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General NPI Number Information
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NPI Number | 1366590820
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Entity Type | Individual
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Provider Name | NILESH S. SHAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 11/01/2019
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Provider Practice Location Address
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Address Line | 1536 N 115TH ST STE 340
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City | SEATTLE
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State | WA
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Zip | 98133-8412
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Country | US
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Telephone | 206-520-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50095
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City | SEATTLE
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State | WA
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Zip | 98145-5095
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Country | US
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Telephone | 206-520-5700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD60086328
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 239514
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License Number State | NY
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