Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sharon D Wallace

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1205478591

Sharon D Wallace is a Nurse Practitioner in Lacey, Washington. Qualified in 2022, 4 years ago. Practices with Greater Lakes Mental Health Foundation Inc, a 19-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
4
Licensed in
WA
In the registry since
2019
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Practice location Address checks out

673 Woodland Square Loop SE Ste 320
Lacey, WA 98503-1066
Phone: (425) 640-7009
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence AP61462632 (WA)

Record details

NPI number1205478591
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 8, 2019
Last updated in NPPESMarch 19, 2026
Certification dateMarch 19, 2026
Mailing address673 Woodland Square Loop Se Ste 320, Lacey, WA 98503-1066

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Greater Lakes Mental Health Foundation Inc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Lacey