Individual provider Active NPI

Sharon Patricia Vaisberg, DO

  • Family Medicine Physician
  • Lynnwood, WA
National Provider Identifier
1376287672
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
W5600 Issued in TX
Practice address
4111 Alderwood Mall Blvd
Lynnwood, WA 98036-6765
Phone
(425) 977-2560
NPI assigned
Apr 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X W5600 TX Primary

Addresses

Primary practice location

4111 Alderwood Mall Blvd
Lynnwood, WA 98036-6765

Mailing address

4111 Alderwood Mall Blvd
Lynnwood, WA 98036-6765
Phone (425) 977-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611002183 WA Practitioner - Family Practice 4789126376 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers CurrentSince Jun 19, 2024 Accepting new patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
Sea Mar Community Health Centers Family Medicine CurrentSince Jun 19, 2024 Accepting new patients

Locations

4111 Alderwood Mall Blvd
Lynnwood, WA 98036
Phone (425) 616-4100

9710 State Ave
Marysville, WA 98270
Phone (360) 653-1742

17707 W Main St
Fl 1
Monroe, WA 98272
Phone (360) 282-3885

Interoperability endpoints

  • Direct secure messaging: svaisberg721409@direct.multicare.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1376287672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 ALDERWOOD MALL BLVD",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366765",
            "telephone_number": "425-977-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 ALDERWOOD MALL BLVD",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366765",
            "telephone_number": "425-977-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAISBERG",
        "first_name": "SHARON",
        "middle_name": "PATRICIA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "W5600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.