Provider Demographics
NPI:1962400374
Name:KNAPP, SHARON BARBARA (NP)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:BARBARA
Last Name:KNAPP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3226 NE 56TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-3336
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16126 SE HAPPY VALLEY TOWN CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97086-4256
Practice Address - Country:US
Practice Address - Phone:503-658-1777
Practice Address - Fax:503-454-0505
Is Sole Proprietor?:No
Enumeration Date:2005-07-09
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR079043485RN163WC0200X
OR200150107NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR041178OtherCARE OREGON
OR297459OtherOMAP
ORANP 0315OtherOREGON WORKER COMPENSATIO
OR041178OtherCARE OREGON
ORP85550Medicare UPIN