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General NPI Number Information
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NPI Number | 1366646788
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Entity Type | Individual
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Provider Name | MOLLY A SHAW R.D.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2124 4TH AVE
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City | SEATTLE
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State | WA
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Zip | 98121-2308
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Country | US
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Telephone | 206-296-4981
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Fax | 206-296-0184
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Provider Business Mailing Address
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Address Line | 11338 34TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98125-6808
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Country | US
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Telephone | 206-367-9167
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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