MEDICARE: PATRICIA A SHIGIHARA, DDS, PS

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
1	261QD0000X	Dental Clinic/Center	5910	WA

General Provider Information

NPI Number	:	1942454277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICIA A SHIGIHARA, DDS, PS

Provider Business Mailing Address
First Line	:	9400 ROOSEVELT WAY NE STE 100
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-2847
Country	:	US
Telephone Number	:	206-362-1121
Fax Number	:	206-362-0151

Provider Business Practice Location Address
First Line	:	9400 ROOSEVELT WAY NE STE 100
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-2847
Country	:	US
Telephone Number	:	206-362-1121
Fax Number	:	206-362-0151

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. PATRICIA SHIGIHARA
Credential	:	DDS
Telephone Number	:	206-362-1121

Provider Enumeration Date	:	11/13/2008
Last Update Date	:	11/13/2008

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