Individual
SHANNON MARIE DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1400 112TH AVE SE, SUITE 100, BELLEVUE, WA 98004-6901
(425) 223-3712
Mailing address
1400 112TH AVE SE, SUITE 100, BELLEVUE, WA 98004-6901
(425) 223-3712
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
603275027
WA
Other
Enumeration date
05/02/2013
Last updated
01/17/2014
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