Provider Demographics
NPI:1316776511
Name:MCCABE, SHARON (PA-C)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:MCCABE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8811 S ALASKA ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-3131
Mailing Address - Country:US
Mailing Address - Phone:253-973-1470
Mailing Address - Fax:
Practice Address - Street 1:8811 S ALASKA ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-3131
Practice Address - Country:US
Practice Address - Phone:253-973-1470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61463091207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology