Provider Demographics
NPI:1831165547
Name:SHERMAN, GRISELLE (MD)
Entity type:Individual
Prefix:DR
First Name:GRISELLE
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GRISELLE
Other - Middle Name:
Other - Last Name:AYALA-COLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11610 TERRY LAKE RD SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-2714
Mailing Address - Country:US
Mailing Address - Phone:917-445-8260
Mailing Address - Fax:
Practice Address - Street 1:BLDG 9040 JACKSON AVENUE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-5109
Practice Address - Country:US
Practice Address - Phone:253-968-5068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1135208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics