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Individual

ERIC R SHIPLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1035 116TH AVE NE, BELLEVUE, WA 98004-4604
(425) 688-5124
Mailing address
PO BOX 34960, SEATTLE, WA 98124-1960
(425) 656-4255
(425) 656-4003

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD00038537
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0185720
LABOR&INDUSTRIES PROV #
WA
01
5272SH
REGENCE B/S PROV #
WA
05
8256299
WA
Enumeration date
09/01/2006
Last updated
07/30/2010
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