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NPI Code Detail

MEDICARE: MR. SHILOH COCKETT LMP

MEDICARE: MR. SHILOH COCKETT LMP
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
1174400000XSpecialistMA00013705WA

General Provider Information

NPI Number : 1396968244
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SHILOH COCKETT LMP
Provider Business Mailing Address
First Line : 8019 222ND ST SW
Second Line :
City : EDMONDS
State : WA
Zip : 98026-8152
Country : US
Telephone Number : 425-508-1914
Fax Number :
Provider Business Practice Location Address
First Line : 6823 OSWEGO PL NE
Second Line : SUITE #1
City : SEATTLE
State : WA
Zip : 98115-8415
Country : US
Telephone Number : 206-527-9709
Fax Number : 206-526-2991
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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Directions to “ MR. SHILOH COCKETT LMP” Practice Location

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