Individual
SHIKOTA BRIDGEMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5007 W AUGUSTA BLVD, CHICAGO, IL 60651-4471
(313) 998-5527
Mailing address
10720 5TH AVE NE, SEATTLE, WA 98125-7260
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN61263932
WA
163WC1500X
Community Health Registered Nurse
RN61263932
WA
Other
Enumeration date
07/19/2025
Last updated
07/19/2025
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