Provider Demographics
NPI:1558752170
Name:SHARP, MOLLIE MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:MOLLIE
Middle Name:MARIE
Last Name:SHARP
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MOLLIE
Other - Middle Name:
Other - Last Name:MCDANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22717 SE 29TH ST STE D-101
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-9532
Mailing Address - Country:US
Mailing Address - Phone:425-269-3277
Mailing Address - Fax:425-968-1274
Practice Address - Street 1:22717 SE 29TH ST STE D-101
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075
Practice Address - Country:US
Practice Address - Phone:425-269-3277
Practice Address - Fax:425-968-1274
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60276437163WP0808X
WAAP60782636363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health