Latta, Shannon Michal
Latta, Shannon Michal is an individual health care provider with primary practice located at 4420 76Th St Ne , Marysville WA 98270-3726. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Latta, Shannon Michal can be contacted via phone (360) 651-7490.Contact Information
Primary practice address
4420 76Th St Ne
Marysville WA 98270-3726
Phone: (360) 651-7490
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | AP60098107 | Washington |
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP60098107 | Washington |
Profile Details
NPI number | 1194956672 |
---|---|
LBN Legal business name | Latta, Shannon Michal |
Credentials | ARNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 2nd, 2009 |
Last updated | Dec 13th, 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1194956672 | NPPES |
Washington | MEDICAID | 9662628 | |
Washington | Other | 0254476 | |
Washington | MEDICAID | 2003611 |
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