Provider Demographics
NPI:1689798605
Name:MCCAIN, SHARI-RAE
Entity Type:Individual
Prefix:MRS
First Name:SHARI-RAE
Middle Name:
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13101 64TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-4619
Mailing Address - Country:US
Mailing Address - Phone:206-313-2529
Mailing Address - Fax:
Practice Address - Street 1:620 SW SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-2201
Practice Address - Country:US
Practice Address - Phone:425-255-6202
Practice Address - Fax:425-917-9629
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019763174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist