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General NPI Number Information
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NPI Number | 1760280184
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Entity Type | Individual
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Provider Name | SHANNON MEGAN POLLOCK LPN
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Gender | Female
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 7224 PACIFIC HWY E
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City | MILTON
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State | WA
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Zip | 98354-9654
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Country | US
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Telephone | 253-205-0175
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Fax |
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Provider Business Mailing Address
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Address Line | 12428 AQUEDUCT DR E
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City | TACOMA
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State | WA
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Zip | 98445-3636
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Country | US
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Telephone | 253-370-2869
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP00042009
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License Number State | WA
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