Keck, Shane A

Keck, Shane A is an individual health care provider with primary practice located at 3100 Carillon Pt , Kirkland WA 98033-7306. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Keck, Shane A can be contacted via phone (425) 576-1700.

Contact Information

Primary practice address
3100 Carillon Pt Kirkland WA 98033-7306
Phone: (425) 576-1700
Fax: (425) 827-7725
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1187 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60021277 Washington

Profile Details

NPI number 1134308067
LBN Legal business name Keck, Shane A
Credentials MPA,PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2007
Last updated Sep 4th, 2012 - about 12 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 1134308067 NPPES
Kansas MEDICAID 200536260A

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