Provider Demographics
NPI:1598035925
Name:SALVERDA, SHARA MAE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SHARA
Middle Name:MAE
Last Name:SALVERDA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NW 11TH ST
Mailing Address - Street 2:SUITE E-15
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-8602
Mailing Address - Country:US
Mailing Address - Phone:541-567-6434
Mailing Address - Fax:541-567-6019
Practice Address - Street 1:600 NW 11TH ST
Practice Address - Street 2:SUITE E-15
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-8602
Practice Address - Country:US
Practice Address - Phone:541-567-6434
Practice Address - Fax:541-567-6019
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201150189NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily