Provider Demographics
NPI:1942559885
Name:CARTER, SHARON LEA
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LEA
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:LEA
Other - Last Name:KREITZBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AA, BA, MA
Mailing Address - Street 1:11007 NW 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-4103
Mailing Address - Country:US
Mailing Address - Phone:360-798-0331
Mailing Address - Fax:
Practice Address - Street 1:800 NW 99TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-7512
Practice Address - Country:US
Practice Address - Phone:360-313-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00001867235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist