Individual
SHANE SELASSIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
1001 SW KLICKITAT WAY, 205, SEATTLE, WA 98134-1161
(206) 622-7747
(206) 467-1470
Mailing address
PO BOX 34245, SEATTLE, WA 98124-1245
(206) 622-7747
(206) 467-1470
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
MD00039332
WA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
79786
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD00039332
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142146
ST LABOR INDUSTRIES
WA
05
—
8416026
—
WA
Enumeration date
11/18/2005
Last updated
02/26/2026
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