| David P Shaw Md Ps Inc | |
|
470 Front St N Issaquah WA 98027-2914 | |
| (253) 520-0158 | |
| Not Available |
| Full Name | David P Shaw Md Ps Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 470 Front St N, Issaquah, Washington |
| Authorized Official Name and Position | Dana Ralph (BILLING MANAGER) |
| Authorized Official Contact | 2535200158 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David P Shaw Md Ps Inc Po Box 5202 Kent WA 98064-5202 Ph: () - | David P Shaw Md Ps Inc 470 Front St N Issaquah WA 98027-2914 Ph: (253) 520-0158 |
| NPI Number | 1992235279 |
|---|---|
| Provider Enumeration Date | 06/19/2017 |
| Last Update Date | 06/19/2017 |
| Medicare PECOS PAC ID | 6800155953 |
|---|---|
| Medicare Enrollment ID | O20180117001356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992235279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | David P Shaw |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003971904 PECOS PAC ID: 5496821886 Enrollment ID: I20080909000385 |
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