Provider Demographics
NPI:1750301750
Name:GRIFFIN, SHARON ANN (ND)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:ANN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 NE BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1430
Mailing Address - Country:US
Mailing Address - Phone:503-542-4485
Mailing Address - Fax:503-282-5966
Practice Address - Street 1:1832 NE BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1430
Practice Address - Country:US
Practice Address - Phone:503-542-4485
Practice Address - Fax:503-282-5966
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1490175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath