Individual
SHANNON EAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP, RN
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
RN60170208
WA
225700000X
Massage Therapist
MA00022115
WA
363L00000X
Nurse Practitioner
AP60652210
WA
367A00000X
Advanced Practice Midwife
Primary
AP60652210
WA
Other
Enumeration date
03/12/2007
Last updated
04/26/2021
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