Provider Demographics
NPI:1912052887
Name:SCHELLINGER, SHARON J
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:J
Last Name:SCHELLINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18870 8TH AVE NE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-6233
Mailing Address - Country:US
Mailing Address - Phone:360-394-4444
Mailing Address - Fax:360-394-4448
Practice Address - Street 1:18870 8TH AVE NE
Practice Address - Street 2:SUITE 203
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6233
Practice Address - Country:US
Practice Address - Phone:360-394-4444
Practice Address - Fax:360-394-4448
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY3115103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8809153Medicare ID - Type Unspecified