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General NPI Number Information
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NPI Number | 1902820913
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Entity Type | Individual
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Provider Name | SHIRLEY ANN KING PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 14731 AURORA AVE N
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City | SHORELINE
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State | WA
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Zip | 98133-6547
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Country | US
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Telephone | 206-365-0220
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Fax | 206-365-6436
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Provider Business Mailing Address
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Address Line | 14008 81ST AVE NE
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City | BOTHELL
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State | WA
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Zip | 98011-5337
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Country | US
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Telephone | 425-821-2049
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10003773
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License Number State | WA
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