Individual
PHILLIP LUTHER SHEALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP, FNP
Contact information
Practice address
801 SW 16TH ST., STE. 121, RENTON, WA 98057-2628
(206) 805-8885
(206) 805-8886
Mailing address
23745 225TH WAY SE, STE 201, MAPLE VALLEY, WA 98038-5294
(803) 943-8358
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60508185
WA
Other
Enumeration date
12/04/2014
Last updated
03/22/2017
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