Individual
SHANE A KECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPA,PA-C
Contact information
Practice address
3100 CARILLON PT, KIRKLAND, WA 98033-7306
(425) 576-1700
(425) 827-7725
Mailing address
3100 CARILLON POINT, KIRKLAND, WA 98033-7306
(425) 576-1700
(425) 827-7725
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1187
KS
363A00000X
Physician Assistant
Primary
PA60021277
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200536260A
—
KS
Enumeration date
10/27/2007
Last updated
09/04/2012
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