Provider Demographics
NPI:1154367118
Name:ENGSTROM, SHARI C (MD)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:C
Last Name:ENGSTROM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:206-543-6420
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-598-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00035912207P00000X
CAG063415207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI0879OtherREGENCE BS
184574OtherWA L & I
WA0227516OtherLIWA
WA1451ENOtherBSWA
8938314OtherCRIME VICTIM
WA8228744Medicaid
WA605960013OtherUSDLAB
WAG8802632Medicare PIN
WA1451ENOtherBSWA
184574OtherWA L & I
E26948Medicare UPIN