Provider Demographics
NPI:1164933867
Name:SHARP, SARAH ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ANNE
Last Name:SHARP
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:
Other - Last Name:SHARP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1155 SE CITY BEACH ST UNIT 838
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-2937
Mailing Address - Country:US
Mailing Address - Phone:719-352-1635
Mailing Address - Fax:206-231-5075
Practice Address - Street 1:1370 SW FAIRHAVEN DR
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-4540
Practice Address - Country:US
Practice Address - Phone:719-352-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-20
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4694103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical