Provider Demographics
NPI:1194070300
Name:LUCHINO, SHARI L (DNP, ARNP, CNM)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:L
Last Name:LUCHINO
Suffix:
Gender:F
Credentials:DNP, ARNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16045 1ST AVE S FL 2
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98148-1401
Mailing Address - Country:US
Mailing Address - Phone:206-965-4200
Mailing Address - Fax:253-552-1239
Practice Address - Street 1:16045 1ST AVE S FL 2
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148-1401
Practice Address - Country:US
Practice Address - Phone:206-965-4200
Practice Address - Fax:253-552-1239
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60299889367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2022759Medicaid