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Individual

SHELLEY D. MIKSIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, ARNP

Contact information

Practice address
1101 MADISON ST STE 1150, SEATTLE, WA 98104-3558
(206) 386-3400
Mailing address
805 MADISON ST STE 901, SEATTLE, WA 98104-1172
(206) 264-8100

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00133781
WA
363LW0102X
Women's Health Nurse Practitioner
Primary
AP30005987
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AP30005987
STATE LICENSE
WA
Enumeration date
09/20/2005
Last updated
04/03/2018
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