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Individual

LISTYA SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
825 EASTLAKE AVE E, SEATTLE, WA 98109-4405
(206) 288-7300
Mailing address
825 EASTLAKE AVE E, SEATTLE, WA 98109-4405

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA60276554
WA

Other

Enumeration date
10/29/2008
Last updated
09/30/2012
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