Provider Demographics
NPI:1427086800
Name:WEST, SHAWN H (MD)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:H
Last Name:WEST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7315 212TH ST SW STE 101
Mailing Address - Street 2:PUGET SOUND FAMILY PHYSICIANS DBA EDMONDS FAMILY MEDICI
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026
Mailing Address - Country:US
Mailing Address - Phone:425-775-9474
Mailing Address - Fax:425-670-3554
Practice Address - Street 1:7315 212TH ST SW STE 101
Practice Address - Street 2:PUGET SOUND FAMILY PHYSICIANS DBA EDMONDS FAMILY MEDICI
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026
Practice Address - Country:US
Practice Address - Phone:425-775-9474
Practice Address - Fax:425-670-3554
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00035365207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8241317Medicaid
WA8241317Medicaid
WA8864419Medicare PIN