Individual
SHANNON MICHELLE DEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4245 ROOSEVELT WAY NE FL 2, SEATTLE, WA 98105-6008
(206) 598-6285
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60641197
WA
363L00000X
Nurse Practitioner
Primary
AP61325865
WA
Other
Enumeration date
03/05/2020
Last updated
12/13/2022
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