Provider Demographics
NPI:1730786252
Name:SHARMAN, ALEXANDRA ELIAS (LIACSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:ELIAS
Last Name:SHARMAN
Suffix:
Gender:F
Credentials:LIACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5735 91ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-5032
Mailing Address - Country:US
Mailing Address - Phone:206-707-2611
Mailing Address - Fax:
Practice Address - Street 1:5735 91ST AVE SE
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-5032
Practice Address - Country:US
Practice Address - Phone:206-707-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA610890121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical