Provider Demographics
NPI:1750424636
Name:EINHORN DICKS, SHARI LYNN (MS PT)
Entity type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:LYNN
Last Name:EINHORN DICKS
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:LYNN
Other - Last Name:DICKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSPT
Mailing Address - Street 1:1188 106TH AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-8614
Mailing Address - Country:US
Mailing Address - Phone:425-454-4864
Mailing Address - Fax:425-646-3901
Practice Address - Street 1:901 BOREN AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3595
Practice Address - Country:US
Practice Address - Phone:206-447-1570
Practice Address - Fax:206-447-1592
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0004168OtherL&I
WAG8890910Medicare PIN
WA8859608Medicare ID - Type Unspecified