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NPI Code Detail

MEDICARE: SHELLY KAYE NEWCOMER LMP

MEDICARE: SHELLY KAYE NEWCOMER LMP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMA00008350WA

General Provider Information

NPI Number : 1083752695
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLY KAYE NEWCOMER LMP
Provider Business Mailing Address
First Line : 4860 RAINIER AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98118-6305
Country : US
Telephone Number : 206-551-9460
Fax Number :
Provider Business Practice Location Address
First Line : 4860 RAINIER AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98118-6305
Country : US
Telephone Number : 206-551-9460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2007
Last Update Date : 02/18/2015

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Directions to “ SHELLY KAYE NEWCOMER LMP” Practice Location

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