Provider Demographics
NPI:1598856379
Name:SHIRMAN, AMOS (MD)
Entity Type:Individual
Prefix:DR
First Name:AMOS
Middle Name:
Last Name:SHIRMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 23RD AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-2921
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16110 8TH AVE SW STE C1
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2996
Practice Address - Country:US
Practice Address - Phone:206-835-1960
Practice Address - Fax:206-835-1963
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00029547207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1108620Medicaid
WA131854OtherLABOR AND INDUSTRIES
WA131854OtherLABOR AND INDUSTRIES
WA1108620Medicaid