Stack, Shobha Williamson

Stack, Shobha Williamson is an individual health care provider with primary practice located at 12040 Ne 128Th St , Kirkland WA 98034-3013. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is her primary health care specialty. Stack, Shobha Williamson can be contacted via phone (425) 542-3630.

Contact Information

Primary practice address
12040 Ne 128Th St Kirkland WA 98034-3013
Phone: (425) 542-3630
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD60503747 Washington
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207RH0002X 60503747 Washington

Profile Details

NPI number 1982993770
LBN Legal business name Stack, Shobha Williamson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2011
Last updated Jul 16th, 2022 - about 2 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 1982993770 NPPES
Washington Other 8936088 MEDICARE PIN
Washington MEDICAID 1982993770 MEDICARE PIN

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