Provider Demographics
NPI:1336555622
Name:MACDONALD, SHARON ANN (DPT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 N HUDSON AVE
Mailing Address - Street 2:APT 105E
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-4421
Mailing Address - Country:US
Mailing Address - Phone:616-218-4353
Mailing Address - Fax:
Practice Address - Street 1:290 N HUDSON AVE
Practice Address - Street 2:APT 105E
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4421
Practice Address - Country:US
Practice Address - Phone:616-218-4353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist