Individual
DR. SHANE MANDALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OP60938359
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063806925
—
WA
Enumeration date
03/27/2015
Last updated
06/20/2019
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