Provider Demographics
NPI:1720332471
Name:DEERING, SHARON LYNNE (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNNE
Last Name:DEERING
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23914 33RD DR SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-8935
Mailing Address - Country:US
Mailing Address - Phone:425-408-7066
Mailing Address - Fax:
Practice Address - Street 1:3330 MONTE VILLA PARKWAY
Practice Address - Street 2:NORTHSHORE SCHOOL DISTRICT
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021
Practice Address - Country:US
Practice Address - Phone:425-408-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00003174235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist