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NPI Code Detail

MEDICARE: SHANNON QUINLAN

MEDICARE: SHANNON QUINLAN
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
1225700000XMassage TherapistMA60399384WA

General Provider Information

NPI Number : 1942612346
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON QUINLAN
Provider Business Mailing Address
First Line : 2101 SW SUNSET BLVD APT B303
Second Line :
City : RENTON
State : WA
Zip : 98057-6122
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 916 NE 65TH ST
Second Line :
City : SEATTLE
State : WA
Zip : 98115-5542
Country : US
Telephone Number : 206-267-0863
Fax Number : 206-267-0814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2014
Last Update Date : 05/20/2014

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Directions to “ SHANNON QUINLAN ” Practice Location

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