Provider Demographics
NPI:1821494600
Name:SHARA, NATHANIEL (LCSW)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:
Last Name:SHARA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 E SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5746
Mailing Address - Country:US
Mailing Address - Phone:206-595-2875
Mailing Address - Fax:
Practice Address - Street 1:1123 E JOHN ST STE 5
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-6117
Practice Address - Country:US
Practice Address - Phone:206-595-2875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical