Provider Demographics
NPI:1962876318
Name:ALLISON, SHARON ELIZABETH (DAOM)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:ELIZABETH
Last Name:ALLISON
Suffix:
Gender:F
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6707 NE SACRAMENTO ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-4753
Mailing Address - Country:US
Mailing Address - Phone:503-360-3130
Mailing Address - Fax:
Practice Address - Street 1:6707 NE SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-4753
Practice Address - Country:US
Practice Address - Phone:503-360-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA156567171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist