Individual
SHANE SUE WHITEHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5801 SAND POINT WAY NE, SEATTLE, WA 98105-2147
(206) 987-4585
Mailing address
7015 25TH AVE NE, SEATTLE, WA 98115-5811
(314) 435-5954
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61450508
WA
Other
Enumeration date
03/03/2022
Last updated
08/07/2023
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