Individual
JACKIE SUE SHUEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1105 S 348TH ST STE B103, FEDERAL WAY, WA 98003-7027
(250) 323-7800
(253) 661-9132
Mailing address
1105 S 348TH ST STE B103, FEDERAL WAY, WA 98003-7027
(253) 237-8050
(253) 661-9132
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10004350
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8372269
—
WA
Enumeration date
07/07/2005
Last updated
01/24/2025
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