Provider Demographics
NPI:1962168617
Name:SANMARTINO, SHARRON (LAC)
Entity type:Individual
Prefix:
First Name:SHARRON
Middle Name:
Last Name:SANMARTINO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10285 NE BARKENTINE RD
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-3714
Mailing Address - Country:US
Mailing Address - Phone:310-463-3466
Mailing Address - Fax:
Practice Address - Street 1:5355 WELFARE AVE NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-3179
Practice Address - Country:US
Practice Address - Phone:310-463-3466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61201713171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist