Healthcare Provider Details

I. General information

NPI: 1962084434
Provider Name (Legal Business Name): PATRICIA SHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2021
Last Update Date: 11/05/2026
Certification Date: 11/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12900 NE 180TH ST STE 201
BOTHELL WA
98011-5773
US

IV. Provider business mailing address

12900 NE 180TH ST STE 201
BOTHELL WA
98011-5773
US

V. Phone/Fax

Practice location:
  • Phone: 206-922-2376
  • Fax: 253-276-6624
Mailing address:
  • Phone: 206-922-2376
  • Fax: 253-276-6624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD.MD.70149829
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: