Provider Demographics
NPI:1720179609
Name:SHERMAN, CAROLYN E (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:E
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 TALLMAN AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3932
Mailing Address - Country:US
Mailing Address - Phone:206-320-3335
Mailing Address - Fax:206-320-8027
Practice Address - Street 1:5350 TALLMAN AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3932
Practice Address - Country:US
Practice Address - Phone:206-320-3335
Practice Address - Fax:206-320-8027
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00038702208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8255275Medicaid
WAH06032Medicare UPIN
WAG8878070Medicare PIN
WAG8853810Medicare PIN