Provider Demographics
NPI:1124250519
Name:MURRELL, SHARON JEAN (LMT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:JEAN
Last Name:MURRELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:JEAN
Other - Last Name:KOSMICKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 E HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2824
Mailing Address - Country:US
Mailing Address - Phone:503-869-5232
Mailing Address - Fax:
Practice Address - Street 1:200 E HANCOCK ST
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2824
Practice Address - Country:US
Practice Address - Phone:503-869-5232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16165174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist