Healthcare Provider Details

I. General information

NPI: 1477942654
Provider Name (Legal Business Name): SHANNON ESTRADA N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 10/01/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 13581
MILL CREEK WA
98082
US

IV. Provider business mailing address

PO BOX 13581
MILL CREEK WA
98082
US

V. Phone/Fax

Practice location:
  • Phone: 206-486-0967
  • Fax: 206-319-4514
Mailing address:
  • Phone: 206-486-0967
  • Fax: 206-319-4514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60513331
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: