Provider Demographics
NPI:1356396089
Name:HAMMOND, SHARON (CNM)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 NE BLAKELY DR
Mailing Address - Street 2:SUITE 2030
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-6201
Mailing Address - Country:US
Mailing Address - Phone:142-531-3708
Mailing Address - Fax:425-313-7174
Practice Address - Street 1:751 NE BLAKELY DR
Practice Address - Street 2:SUITE 2030
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-6201
Practice Address - Country:US
Practice Address - Phone:142-531-3708
Practice Address - Fax:425-313-7174
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007675367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB18652OtherMEDICARE PROVIDER NUMBER
S06940Medicare UPIN