Provider Demographics
NPI:1063181998
Name:SHOKATI, SAMIRA (ARNP)
Entity type:Individual
Prefix:
First Name:SAMIRA
Middle Name:
Last Name:SHOKATI
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13023 84TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-2658
Mailing Address - Country:US
Mailing Address - Phone:206-604-8911
Mailing Address - Fax:866-341-1092
Practice Address - Street 1:13110 NE 177TH PL STE B102
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-5742
Practice Address - Country:US
Practice Address - Phone:425-900-2872
Practice Address - Fax:866-341-1092
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61349892363LF0000X
WARN60970141163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily