Provider Demographics
NPI:1407166879
Name:SHAW, KERI ANNE (MSAOM, LAC, LMP)
Entity Type:Individual
Prefix:MRS
First Name:KERI
Middle Name:ANNE
Last Name:SHAW
Suffix:
Gender:F
Credentials:MSAOM, LAC, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4915 48TH AVE. S.
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118
Mailing Address - Country:US
Mailing Address - Phone:206-399-7638
Mailing Address - Fax:206-725-4543
Practice Address - Street 1:1818 WESTLAKE AVE N
Practice Address - Street 2:STE 126
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2777
Practice Address - Country:US
Practice Address - Phone:206-217-8888
Practice Address - Fax:206-217-8881
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60182089171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist