Provider Demographics
NPI:1174281661
Name:MATSUNANGA, SHARINE KOYAR ENTICE (BSN RN)
Entity Type:Individual
Prefix:
First Name:SHARINE KOYAR
Middle Name:ENTICE
Last Name:MATSUNANGA
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WEST SEATTLE 2600 SW HOLDEN ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126
Mailing Address - Country:US
Mailing Address - Phone:206-933-7000
Mailing Address - Fax:
Practice Address - Street 1:WEST SEATTLE 2600 SW HOLDEN ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98126
Practice Address - Country:US
Practice Address - Phone:206-933-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61223758163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty