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NPI Code Detail

MEDICARE: SHAWN NOOR M.D.,

MEDICARE: SHAWN NOOR M.D.,
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
1390200000XStudent in an Organized Health Care Education/Training Program27825OK
22084P0800XPsychiatry Physician27825OK
32084P0800XPsychiatry PhysicianMD60443335WA

General Provider Information

NPI Number : 1902119233
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWN NOOR M.D.,
Provider Business Mailing Address
First Line : 6505 86TH AVE W
Second Line :
City : UNIVERSITY PLACE
State : WA
Zip : 98467-4066
Country : US
Telephone Number : 425-761-1268
Fax Number :
Provider Business Practice Location Address
First Line : 9601 STEILACOOM BLVD SW
Second Line :
City : LAKEWOOD
State : WA
Zip : 98498-7212
Country : US
Telephone Number : 253-582-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2010
Last Update Date : 02/09/2015

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Directions to “ SHAWN NOOR M.D.,” Practice Location

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