Individual
MISS SHANNON ELISABETH PERCIVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
202 N DIVISION ST, AUBURN, WA 98001-4939
(253) 333-2564
Mailing address
4950 CORSON AVE S, SEATTLE, WA 98108-1835
(206) 799-9647
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60246035
WA
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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