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General NPI Number Information
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NPI Number | 1982781944
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Entity Type | Individual
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Provider Name | SANG IK SHIN MD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 21601 76TH AVE W
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City | EDMONDS
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State | WA
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Zip | 98026-7507
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Country | US
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Telephone | 425-640-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 84026
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City | SEATTLE
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State | WA
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Zip | 98124-8426
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Country | US
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Telephone | 206-320-4476
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Fax | 206-568-7043
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 248541
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD60319510
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 7308
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License Number State | AK
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