Individual
DR. SHANE OP BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
450 S KITSAP BLVD, #100, PORT ORCHARD, WA 98366-3773
(360) 744-6275
(360) 895-6296
Mailing address
450 S KITSAP BLVD, #100, PORT ORCHARD, WA 98366-3773
(360) 744-6275
(360) 895-6296
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OP00001839
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0171367
LIWA
WA
01
—
0181442
LIWA
WA
01
—
1594BR
BSWA
WA
01
—
2165BR
BSWA
WA
05
—
8326985
—
WA
01
—
BSWA
2264BR
WA
Enumeration date
06/14/2006
Last updated
12/13/2010
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