Individual
MS. MATTIE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
4110 STONE WAY N, SUITE 201, SEATTLE, WA 98103-8000
(206) 992-2482
Mailing address
4110 STONE WAY N, SUITE 201, SEATTLE, WA 98103-8000
(206) 992-2482
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00003216
WA
Other
Enumeration date
09/17/2006
Last updated
07/08/2007
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