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General NPI Number Information
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NPI Number | 1609205640
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Entity Type | Individual
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Provider Name | ERIN E SHELBY MA
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Gender | Female
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 15021 MAIN ST SUITE K
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City | MILL CREEK
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State | WA
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Zip | 98012-1651
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Country | US
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Telephone | 425-948-7856
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Fax |
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Provider Business Mailing Address
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Address Line | 720 168TH PL SW APT 107
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City | LYNNWOOD
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State | WA
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Zip | 98037-3311
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Country | US
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Telephone | 425-387-9012
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MA 60237731
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License Number State | WA
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