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Individual
DR. SHANNON B RADKE
Active
Individual
DR. SHANNON B RADKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00036530
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806529300
—
ID
05
—
8345274
—
WA
Enumeration date
09/28/2006
Last updated
03/18/2025
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