Individual
MR. MICHAEL BRENDAN SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 9TH AVE # 359606, SEATTLE, WA 98104-2420
(206) 744-4933
(206) 744-2252
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD60654692
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538119607
—
WA
01
—
8954855
MEDICARE PIN
WA
Enumeration date
05/11/2006
Last updated
07/21/2022
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