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Individual

CHRISTOPHER JOEL SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
11800 NE 128TH ST, SUITE 300, KIRKLAND, WA 98034-7208
(425) 814-5100
(425) 814-5103
Mailing address
13236 NE 129TH PL, KIRKLAND, WA 98034-3361
(425) 814-5100
(425) 814-5103

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60124508
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0260915
L AND I
WA
05
1407179690
WA
01
P00946049
RAILROAD MEDICARE
WA
Enumeration date
03/02/2010
Last updated
02/09/2015
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