Provider Demographics
NPI:1295938066
Name:COCHRAN, SHARRON ELAINE (LAC)
Entity type:Individual
Prefix:
First Name:SHARRON
Middle Name:ELAINE
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 N PROCTOR ST
Mailing Address - Street 2:PMB #436
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-5338
Mailing Address - Country:US
Mailing Address - Phone:253-278-5551
Mailing Address - Fax:
Practice Address - Street 1:2601 E D ST
Practice Address - Street 2:SUITE 303
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98421-1306
Practice Address - Country:US
Practice Address - Phone:253-404-1515
Practice Address - Fax:253-404-1717
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA00000363171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist