Provider Demographics
NPI:1457360794
Name:METCALF, SHARON LEE (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LEE
Last Name:METCALF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3360
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:916 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4147
Practice Address - Country:US
Practice Address - Phone:425-258-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037434207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA174127OtherL & I
WA176736OtherL & I
WA8242786Medicaid
WA8933557OtherCRIME VICTIMS
WA0192484OtherL & I
WA8933560OtherCRIME VICTIMS
WA176736OtherL & I
WA8933557OtherCRIME VICTIMS
WAG8850896Medicare PIN
WAGAB39882Medicare PIN
G95204Medicare UPIN