Individual
SHELLIE ANN RABIDOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
916 KOALA DR, OMAK, WA 98841-9759
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004975
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396745626
—
WA
01
—
314765
LNI
WA
01
—
G8924576
MEDICARE
WA
Enumeration date
07/28/2005
Last updated
08/19/2022
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