Individual
SHANNON TAYLOR CORRIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 S 43RD ST, ER DEPT, RENTON, WA 98055-5714
(425) 228-3450
Mailing address
PO BOX 24584, SEATTLE, WA 98124-0584
(425) 656-4255
(425) 656-4003
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD00041173
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0185268
LABOR&IND PROV BILLING #
WA
01
—
5532CO
REGENCE BS PROV #
WA
05
—
8317091
—
WA
Enumeration date
07/25/2006
Last updated
05/04/2010
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