Individual
BRET E SHUPACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1331 HARBOR AVE SW, STE 100, SEATTLE, WA 98116
(206) 933-9300
(206) 933-9301
Mailing address
1331 HARBOR AVE SW, STE 100, SEATTLE, WA 98116
(206) 933-9300
(206) 933-9301
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00007765
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2684014
UT ACCT #
FL
Enumeration date
03/12/2007
Last updated
07/08/2007
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