Provider Demographics
NPI:1689880783
Name:FENTON, SHARON MARLETTA (CDP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARLETTA
Last Name:FENTON
Suffix:
Gender:F
Credentials:CDP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:MARLETTA
Other - Last Name:STEPHENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDP
Mailing Address - Street 1:2111 N NORTHGATE WAY
Mailing Address - Street 2:SUITE 212
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9018
Mailing Address - Country:US
Mailing Address - Phone:206-781-2661
Mailing Address - Fax:206-781-2749
Practice Address - Street 1:2111 N NORTHGATE WAY
Practice Address - Street 2:SUITE 212
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9018
Practice Address - Country:US
Practice Address - Phone:206-781-2661
Practice Address - Fax:206-781-2749
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00026490101Y00000X
WACP00003056101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)