Individual
SHANNON D. GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1344 WINTERGREEN LN NE STE 100, BAINBRIDGE ISLAND, WA 98110-5118
(206) 201-0488
Mailing address
1344 WINTERGREEN LN NE UNIT 100, BAINBRIDGE ISLAND, WA 98110-5147
(206) 201-0488
(206) 201-0490
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A103930
CA
207P00000X
Emergency Medicine Physician
Primary
MD60612568
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2130389
—
WA
Enumeration date
04/16/2008
Last updated
10/13/2020
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