Anderson, Shane Selassie

Anderson, Shane Selassie is an individual health care provider with primary practice located at 1001 Sw Klickitat Way 205, Seattle WA 98134-1161. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Anderson, Shane Selassie can be contacted via phone (206) 622-7747.

Contact Information

Primary practice address
1001 Sw Klickitat Way 205 Seattle WA 98134-1161
Phone: (206) 622-7747
Fax: (206) 467-1470
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ZD0900X MD00039332 Washington
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X MD00039332 Washington

Profile Details

NPI number 1952383432
LBN Legal business name Anderson, Shane Selassie
Credentials MD PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
Last updated Apr 15th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952383432 NPPES
Washington MEDICAID 8416026
Washington Other 142146

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