Individual
DR. SHANNON RYLEE BALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1100 GOETHALS DR FL 1, RICHLAND, WA 99352-3300
(509) 942-3288
(509) 946-9389
Mailing address
3900 S ZINTEL WAY, KENNEWICK, WA 99337-5092
(509) 942-3627
(509) 942-2268
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A101730
CA
207R00000X
Internal Medicine Physician
MD60249292
WA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD60249292
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0289445
LABOR & INDUSTRIES
WA
05
—
2017649
—
WA
01
—
MD60249292
WA MEDICAL LICENSE
WA
Enumeration date
10/14/2008
Last updated
03/07/2023
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