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Individual

MRS. JEANINE MARIE SHEERAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
9040 JACKSON AVE, TACOMA, WA 98431-2654
(253) 968-1541
(253) 968-2895
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-2654
(253) 968-1541
(253) 968-2895

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085-001804
IL
363AS0400X
Surgical Physician Assistant
10000783A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01618941
BC/BS
IL
Enumeration date
09/19/2005
Last updated
03/29/2022
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