Individual
SHERROD SHIVELEY
Active
Individual
SHERROD SHIVELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00042247
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0172589
STATE L&I
WA
05
—
8361313
—
WA
01
—
8909714
STATE CRIME VICTIMS
WA
01
—
P00335365
RAILROAD
WA
Enumeration date
10/03/2006
Last updated
11/16/2010
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