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Individual
DR. SHANE OP BROOKS
Active
Individual
DR. SHANE OP BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OP00001839
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0171367
LIWA
WA
01
—
0181442
LIWA
WA
01
—
1594BR
BSWA
WA
01
—
2165BR
BSWA
WA
05
—
8326985
—
WA
01
—
BSWA
2264BR
WA
Enumeration date
06/14/2006
Last updated
12/13/2010
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