Provider Demographics
NPI:1124615976
Name:SHARP, STEPHANIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11835 NE GLENN WIDING DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-9057
Mailing Address - Country:US
Mailing Address - Phone:503-444-6500
Mailing Address - Fax:
Practice Address - Street 1:11835 NE GLENN WIDING DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-9057
Practice Address - Country:US
Practice Address - Phone:503-444-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61085061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist