Provider Demographics
NPI:1265631410
Name:CROOK, SHARON (ARNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:CROOK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14880 NE 24TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5533
Mailing Address - Country:US
Mailing Address - Phone:512-913-7537
Mailing Address - Fax:512-358-4861
Practice Address - Street 1:3066 ISSAQUAH PINE LAKE RD SE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075-7253
Practice Address - Country:US
Practice Address - Phone:425-391-6588
Practice Address - Fax:425-391-8361
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005911364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1265631410Medicare UPIN
WAP00662555Medicare UPIN
WAP00662555Medicare PIN