Individual
DR. DUSTIN LEE SHAWCROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-5947
(800) 336-8614
(253) 838-6418
Mailing address
11567 CANTERWOOD BLVD NW, GIG HARBOR, WA 98332-5812
(253) 530-2100
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
MD25749
OR
207P00000X
Emergency Medicine Physician
Primary
MD60062980
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0246652
LIWA
WA
01
—
0249327
LIWA
WA
01
—
1008SH
BSWA
WA
01
—
1044SH
BSWA
WA
05
—
8537680
—
WA
01
—
8951562
VCR
WA
01
—
P00775117
RRGA
WA
Enumeration date
11/02/2006
Last updated
09/10/2010
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