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General NPI Number Information
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NPI Number | 1467799189
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Entity Type | Individual
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Provider Name | MARY RACHAEL SHANNON AU.D., CCC-A
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Gender | Female
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 5775 SOUNDVIEW DR STE C204
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City | GIG HARBOR
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State | WA
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Zip | 98335-2212
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Country | US
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Telephone | 253-514-8224
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Fax | 253-514-8273
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Provider Business Mailing Address
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Address Line | 9730 3RD AVE NE STE 201
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City | SEATTLE
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State | WA
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Zip | 98115-2023
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Country | US
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Telephone | 206-367-1345
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Fax | 206-367-1366
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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 | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | LD00001070
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | LD00001070
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License Number State | WA
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