Provider Demographics
NPI:1962537845
Name:SHIGIHARA, PATRICIA ANN (DDS,PS)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:SHIGIHARA
Suffix:
Gender:F
Credentials:DDS,PS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 ROOSEVELT WAY NE STE 100
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2847
Mailing Address - Country:US
Mailing Address - Phone:206-362-1121
Mailing Address - Fax:
Practice Address - Street 1:9400 ROOSEVELT WAY NE STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2847
Practice Address - Country:US
Practice Address - Phone:206-362-1121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA59101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA831209OtherUNITED CONCORDIA INS.