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Individual

LAUREN EILEEN SHADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(425) 749-9511
Mailing address
1221 N 88TH ST, SEATTLE, WA 98103-2131
(425) 749-9511

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60918239
WA
363LP0200X
Pediatric Nurse Practitioner
Primary
AP61553983
WA

Other

Enumeration date
07/24/2023
Last updated
05/01/2024
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