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SHARON MACK DERSTINE ARNP
NPI 1104810480
Nurse Practitioner - Women's Health in Port Angeles, WA

Active since September 01, 2005
1106 E 1ST ST, PORT ANGELES, WA 98362(360) 452-2954(360) 457-7683 Get Directions Write a Review

NPPES record last updated: July 11, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sharon Mack Derstine Arnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHARON MACK DERSTINE ARNP (NPI 1104810480) is an individual women's health provider in Port Angeles, Washington, licensed in Washington (AP30005738) and active in the NPI registry since September 2005.

NPPES Registry Identity

NPI1104810480
Entity TypeIndividualFemale
Primary Taxonomy363LW0102X
Provider Legal NameSHARON MACK DERSTINECredential: ARNP
Location Address1106 E 1ST STPort Angeles, WA 98362-4317
Mailing Address1106 E 1st StPort Angeles, WA 98362-4317 · (360) 452-2954 · Fax (360) 457-7683
Phone(360) 452-2954
Fax(360) 457-7683
Sole ProprietorNo
Enumeration DateSeptember 1, 2005
Last NPPES UpdateJuly 11, 2008
✔ NPI 1104810480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LW0102X
License✔ Licensed in WA · AP30005738
1106 E 1ST ST, Port Angeles, WA 98362
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Other Identifiers 3

Medicare ID-Type Unspecified9635632WA
Medicare UPIN6AB39834
Medicare UPINAB39835WA

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FAMILY PLANNING OF CLALLAM COUNTY
Specialist
1106 E 1ST ST
PORT ANGELES, WA 98362
Clallam County (360) 452-2954
CHERI VAN HOOVER CNM
Advanced Practice Midwife
1106 E 1ST ST
PORT ANGELES, WA 98362
Clallam County (360) 452-2954
MS. LYNDA ANN BISHOP CNM ARNP
Nurse Practitioner (Women's Health)
1106 E 1ST ST
PORT ANGELES, WA 98362
Clallam County (360) 452-2954

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sharon Derstine's NPI number?

The NPI number for Sharon Derstine is 1104810480. It was assigned to this individual provider in the NPPES registry on September 1, 2005.

Where is Sharon Derstine located?

Sharon Derstine practices at 1106 E 1st St, Port Angeles, WA 98362. The listed phone number is (360) 452-2954.

What is Sharon Derstine's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

When was this NPI record last updated?

The NPPES record for Sharon Derstine was last updated on July 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.