Healthcare Provider Details

I. General information

NPI: 1598698755
Provider Name (Legal Business Name): SHALYN ELIZABETH PUGH-DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHALYN ELIZABETH PUGH

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 SW 320TH ST STE D2
FEDERAL WAY WA
98023-2292
US

IV. Provider business mailing address

3460 SW 111TH ST
SEATTLE WA
98146-1765
US

V. Phone/Fax

Practice location:
  • Phone: 253-289-6099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: