Provider Demographics
NPI:1376604843
Name:SHARP, GREGORY D (DO)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:D
Last Name:SHARP
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:4120 MERIDIAN STREET
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226
Mailing Address - Country:US
Mailing Address - Phone:360-676-4325
Mailing Address - Fax:360-676-5858
Practice Address - Street 1:4140 MERIDIAN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-5576
Practice Address - Country:US
Practice Address - Phone:360-676-4325
Practice Address - Fax:360-676-5858
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2015-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAOP00001611208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1117977Medicaid
WA159802OtherL & I