Individual
DR. JENNIFER E. SHOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19020 33RD AVE W, STE 210, LYNNWOOD, WA 98036-4746
(425) 563-1500
(425) 563-1374
Mailing address
2323 W ROSE GARDEN LN, PHOENIX, AZ 85027-2530
(602) 521-6252
(623) 842-5640
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
27518
AZ
2085R0202X
Diagnostic Radiology Physician
MD00036174
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194628
L&I PROVIDER NUMBER
WA
01
—
201630
L&I PROVIDER NUMBER
WA
05
—
8234718
—
WA
Enumeration date
01/05/2006
Last updated
01/18/2018
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