Individual
SHANNON MCCONNAUGHEY
Active
Individual
SHANNON MCCONNAUGHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60683655
WA
207RC0000X
Cardiovascular Disease Physician
Primary
M-15691
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689093395
—
WA
01
—
8966461
MEDICARE PIN
WA
Enumeration date
04/09/2014
Last updated
05/18/2022
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