Individual
ERIN D. SHADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1101 MADISON ST., SUITE 1500, SEATTLE, WA 98104
(206) 965-1700
(206) 965-1736
Mailing address
1101 MADISON ST., SUITE 1500, SEATTLE, WA 98104
(206) 965-1700
(206) 965-1736
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DI00001488
WA
363AM0700X
Medical Physician Assistant
Primary
PA60072835
WA
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54991U
REGENCE BLUESHIELD
WA
Enumeration date
07/20/2006
Last updated
10/06/2009
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