Healthcare Provider Details

I. General information

NPI: 1891970430
Provider Name (Legal Business Name): SABRINA SHAHEEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 SOUTH CEDAR ST. SUITE 301 CARDIAC STUDY CENTER, INC., P.S.
TACOMA WA
98405
US

IV. Provider business mailing address

1901 SOUTH CEDAR ST. SUITE 301 CARDIAC STUDY CENTER, INC., P.S.
TACOMA WA
98405
US

V. Phone/Fax

Practice location:
  • Phone: 253-573-7320
  • Fax: 253-627-3191
Mailing address:
  • Phone: 253-573-7320
  • Fax: 253-627-3191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number913152
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD60237200
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: