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General NPI Number Information
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NPI Number | 1710811211
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Entity Type | Individual
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Provider Name | SHIRLEE HADDOCK RN
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Gender | Female
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 3436 MARY ELDER RD NE
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City | OLYMPIA
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State | WA
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Zip | 98506-5050
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Country | US
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Telephone | 360-528-2590
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 KOONTZ RD
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City | CHEHALIS
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State | WA
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Zip | 98532-8420
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Country | US
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Telephone | 760-217-4767
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN70085065
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License Number State | WA
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