Provider Demographics
NPI:1992828297
Name:RICHARDS, SHARON LEE (MA MFT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LEE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NE PARK PLAZA DR STE 200
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5871
Mailing Address - Country:US
Mailing Address - Phone:360-977-8116
Mailing Address - Fax:360-216-7826
Practice Address - Street 1:1438 B ST
Practice Address - Street 2:
Practice Address - City:WASHOUGAL
Practice Address - State:WA
Practice Address - Zip Code:98671-2328
Practice Address - Country:US
Practice Address - Phone:360-977-8116
Practice Address - Fax:360-216-7826
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43293106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist