Brooks, Shane Op

Brooks, Shane Op is an sole proprietor health care provider with primary practice located at 450 S Kitsap Blvd #100, Port Orchard WA 98366-3773. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Brooks, Shane Op can be contacted via phone (360) 744-6275.

Contact Information

Primary practice address
450 S Kitsap Blvd #100 Port Orchard WA 98366-3773
Phone: (360) 744-6275
Fax: (360) 895-6296
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X OP00001839 Washington

Profile Details

NPI number 1154364115
LBN Legal business name Brooks, Shane Op
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Dec 13th, 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 1154364115 NPPES
Washington Other 2165BR BSWA
Washington Other 0181442 BSWA
Washington MEDICAID 8326985 BSWA
Washington Other 0171367 BSWA
Washington Other 1594BR BSWA
Washington Other BSWA BSWA

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