Individual
TANDI SHAMALLAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1909 104TH AVE E UNIT Q304, EDGEWOOD, WA 98372-1674
(425) 616-6267
Mailing address
1909 104TH AVE E UNIT Q304, EDGEWOOD, WA 98372-1674
(425) 616-6267
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP61569561
WA
Other
Enumeration date
07/14/2026
Last updated
07/14/2026
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