Individual
SHIREEN ENETTE KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1304 FAWCETT AVE, SUITE 100, TACOMA, WA 98402-1911
(253) 761-4200
(253) 383-3553
Mailing address
PO BOX 1535, TACOMA, WA 98401-1535
(253) 761-4200
(253) 383-3553
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
00027513
WA
2085R0202X
Diagnostic Radiology Physician
Primary
MD00036228
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0249541
LABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST
WA
01
—
126222
LABOR AND INDUSTRIES/WC TRA
WA
01
—
157409
LABOR AND INDUSTRIES/WC UNION AVENUE OPEN
WA
01
—
300095008
RR MEDICARE UNION AVENUE OPEN
WA
01
—
300095009
RR MEDICARE TRA
WA
01
—
7252KH
REGENCE BLUE SHIELD UNION AVENUE OPEN
WA
05
—
8238743
—
WA
01
—
8951843
LABOR AND INDUSTRIES CRIME VICTIMS-MEDICAL IMAGING ON 1ST
WA
01
—
AB34171
MEDICARE PIN UNION AVE OPEN
WA
01
—
AB36525
MEDICARE PIN TRA KING COUNTY
WA
01
—
G8882898
PTAN-MIO1
WA
01
—
G8927711
PTAN-UAOM
WA
01
—
KH8284
REGENCE BLUE SHIELD TRA
WA
Enumeration date
11/16/2006
Last updated
08/30/2024
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