Provider Demographics
NPI:1154737534
Name:MADZIWA, SHAWN MARIE (ARNP, FNP-C, RN)
Entity type:Individual
Prefix:MRS
First Name:SHAWN
Middle Name:MARIE
Last Name:MADZIWA
Suffix:
Gender:F
Credentials:ARNP, FNP-C, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4111 194TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4604
Mailing Address - Country:US
Mailing Address - Phone:425-835-5200
Mailing Address - Fax:
Practice Address - Street 1:4111 194TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4604
Practice Address - Country:US
Practice Address - Phone:425-835-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60486451163W00000X
OR201808802RN163W00000X
GARN226145163WG0000X
WAAP60488948363L00000X, 363LF0000X
OR201809996NP-PP363LF0000X
WAAP60569998367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife