Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | AP60119769 | WA |
Y | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | RN069901 | GA |
NPI | 1023027406 |
---|---|
Provider Name | Barbara R Shaffer |
First Address | Graham, WA 98338-8437 |
Second Address | Tacoma, WA 98405-3933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 16/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AP60119769 | LICENSE (01) | WA |