Individual
DR. MICHAEL CAROLL SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 MADISON ST STE 800, SWEDISH PEDIATRIC SPECIALTY CARE, SEATTLE, WA 98104-1307
(206) 215-2700
(206) 215-2702
Mailing address
1101 MADISON ST STE 800, SWEDISH PEDIATRIC SPECIALTY CARE, SEATTLE, WA 98104-1307
(206) 215-2700
(206) 215-2702
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD60096471
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8549958
—
WA
05
—
L6647
—
NM
Enumeration date
08/30/2006
Last updated
08/26/2013
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