Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP60897132 | WA |
NPI | 1003382763 |
---|---|
Provider Name | Shannon Troy Presler |
First Address | Seattle, WA 98136-1665 |
Second Address | Seattle, WA 98136-1665 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2018 |
Last Update Date | 21/10/2018 |