Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT197721 | PA |
N | 111NI0900X | Internist | MT197721 | PA |
N | 208000000X | Pediatrician | MT197721 | PA |
Y | 2080P0203X | Pediatric Critical Care Doctor | MD60537534 | WA |
NPI | 1184936239 |
---|---|
Provider Name | Shelton Wiley Wright |
First Address | Seattle, WA 98105-3901 |
Second Address | Seattle, WA 98105-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2010 |
Last Update Date | 15/10/2018 |