Organization
SHINE PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACI SWAN ARNP (CO-OWNER, ARNP)
(225) 715-5242
Entity
Organization
Contact information
Practice address
1600 116TH AVE NE STE 304, BELLEVUE, WA 98004-3057
(225) 715-5242
Mailing address
25676 SE 149TH ST, ISSAQUAH, WA 98027-8331
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/31/2024
Last updated
08/07/2024
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