Siem, Michael Shane
Siem, Michael Shane is an individual health care provider with primary practice located at 1035 116Th Ave Ne , Bellevue WA 98004-4604. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Siem, Michael Shane can be contacted via phone (425) 688-5573.Contact Information
Primary practice address
1035 116Th Ave Ne
Bellevue WA 98004-4604
Phone: (425) 688-5573
Fax: (425) 688-5464
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA60056591 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA60056591 | Washington |
Profile Details
| NPI number | 1245483569 |
|---|---|
| LBN Legal business name | Siem, Michael Shane |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 30th, 2008 |
| Last updated | Dec 10th, 2020 - about 4 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 | 1245483569 | NPPES |
| Washington | Other | 0377413 | L&I-RADIA KING COUNTY |
| Washington | Other | 0377409 | L&I-RADIA KING COUNTY |
| Washington | Other | 0377427 | L&I-RADIA KING COUNTY |
| Washington | MEDICAID | 2011887 | L&I-RADIA KING COUNTY |
| Washington | Other | 0377418 | L&I-RADIA KING COUNTY |
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