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NPI Code Detail

MEDICARE: SHELLIE ANN RABIDOU PA-C

MEDICARE:   SHELLIE ANN RABIDOU  PA-C
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
1363A00000XPhysician AssistantPA10004975WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2G8924576OTHERWAMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1314765OTHERWALNI
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396745626
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLIE ANN RABIDOU PA-C
Provider Business Mailing Address
First Line : 820 N CHELAN AVE
Second Line :
City : WENATCHEE
State : WA
Zip : 98801-2028
Country : US
Telephone Number : 509-663-8711
Fax Number :
Provider Business Practice Location Address
First Line : 916 KOALA DR
Second Line :
City : OMAK
State : WA
Zip : 98841-9759
Country : US
Telephone Number : 509-663-8711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 08/19/2022

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Directions to “ SHELLIE ANN RABIDOU PA-C” Practice Location

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