# DR. SHANNON RYLEE BALES

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1407008113
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | A101730 | CA | — |
| 207R00000X | Internal Medicine Physician | MD60249292 | WA | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | MD60249292 | WA | Yes |

## Other

- **Enumeration date:** 10/14/2008
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0289445 | LABOR & INDUSTRIES | WA |
| 05 | — | 2017649 | — | WA |
| 01 | — | MD60249292 | WA MEDICAL LICENSE | WA |