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NPI Code Detail

MEDICARE: SHANNON S SHAMSELDIN MD

MEDICARE:   SHANNON S SHAMSELDIN  MD
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
1207Q00000XFamily Medicine PhysicianMD00030987WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851475560
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON S SHAMSELDIN MD
Provider Business Mailing Address
First Line : PO BOX 5127
Second Line :
City : EVERETT
State : WA
Zip : 98206-5127
Country : US
Telephone Number : 206-860-5414
Fax Number : 206-720-8462
Provider Business Practice Location Address
First Line : 9709 3RD AVE NE FL 2
Second Line :
City : SEATTLE
State : WA
Zip : 98115-2077
Country : US
Telephone Number : 206-525-5777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 06/19/2025

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Directions to “ SHANNON S SHAMSELDIN MD” Practice Location

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