MEDICARE: SHANNON MARIE BILLAU D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OP60237212	WA

General Provider Information

NPI Number	:	1326290628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON MARIE BILLAU D.O.

Provider Business Mailing Address
First Line	:	3610 MERIDIAN ST
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-1732
Country	:	US
Telephone Number	:	360-318-8800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3015 SQUALICUM PKWY STE 160
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-1906
Country	:	US
Telephone Number	:	360-671-4402
Fax Number	:	360-671-9463

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2008
Last Update Date	:	04/27/2026

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