Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD60230382 | WA |
NPI | 1225342991 |
---|---|
Provider Name | Dr. Shannon Margaret Colohan |
First Address | Seattle, WA 98145 |
Second Address | Seattle, WA 98195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2010 |
Last Update Date | 02/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0284361 | L&I (01) | WA |
1225342991 | (05) | WA |
8902379 | MEDICARE PIN (01) | WA |