Provider Demographics
NPI:1164072104
Name:O'SHEA, SHARONNE E
Entity Type:Individual
Prefix:
First Name:SHARONNE
Middle Name:E
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 VILLAGE DR SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4724
Mailing Address - Country:US
Mailing Address - Phone:360-753-1970
Mailing Address - Fax:
Practice Address - Street 1:4410 VILLAGE DR SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-4724
Practice Address - Country:US
Practice Address - Phone:360-753-1970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist