Grosdidier, Shannon R

Grosdidier, Shannon R is an individual health care provider with primary practice located at 820 N Chelan Ave , Wenatchee WA 98801-2028. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Grosdidier, Shannon R can be contacted via phone (509) 663-8711.

Contact Information

Primary practice address
820 N Chelan Ave Wenatchee WA 98801-2028
Phone: (509) 663-8711
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X MD00043737 Washington

Profile Details

NPI number 1093742660
LBN Legal business name Grosdidier, Shannon R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated May 13th, 2014 - about 10 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 1093742660 NPPES
Washington MEDICAID 1093742660
Washington Other 0188365
Washington Other P01290280

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