Individual
SHANNON R GROSDIDIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD00043737
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0188365
L&I
WA
05
—
1093742660
—
WA
01
—
P01290280
RR MEDICARE
WA
Enumeration date
06/27/2006
Last updated
05/13/2014
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