Provider Demographics
NPI:1235200650
Name:PATTERSON, SHARON ELAINE (OTR/L CHT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ELAINE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:OTR/L CHT
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:ELAINE
Other - Last Name:DOLPHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:360-454-1900
Mailing Address - Fax:425-454-1991
Practice Address - Street 1:2901 174TH ST NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-4743
Practice Address - Country:US
Practice Address - Phone:360-454-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001635225XH1200X
OT00001635225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4176PAOtherREGENCE BLUE SHIELD
WA8343286Medicaid
WA0357106OtherL & I
WA9348286Medicaid
WA4671PAOtherREGENCE BLUE SHIELD
WA5040095OtherAETNA
WA0368143OtherL & I
WA0215186OtherDEPT OF LABOR & INDUSTRY
WA8943189OtherL&I CRIME VICTIMS
WA0357088OtherL & I
WA5476PAOtherREGENCE BLUE SHIELD
WA8343286Medicaid
WAG8953733Medicare PIN
WA0215186OtherDEPT OF LABOR & INDUSTRY
WA4176PAOtherREGENCE BLUE SHIELD
WA5476PAOtherREGENCE BLUE SHIELD
WAG8953743Medicare PIN