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Individual

MRS. SHAVONNE C TONNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
707 228TH ST SW, BOTHELL, WA 98021-9799
(425) 742-7953
(425) 742-3683
Mailing address
6307 147TH ST SW, EDMONDS, WA 98026-3649
(425) 742-7953
(425) 742-3683

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004725
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0195262
DEPT OF LABOR INDUSTRY
WA
01
7340T0
ROGENCE BLUE SHIELD
05
8422560
WA
01
P00206112
RAIL ROAD MEDICARE
Enumeration date
08/05/2006
Last updated
07/08/2007
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