Provider Demographics
NPI:1801203088
Name:NASH, SHAWN K (DO)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:K
Last Name:NASH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MADISON ST STE 600
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1340
Mailing Address - Country:US
Mailing Address - Phone:206-215-2020
Mailing Address - Fax:206-215-2022
Practice Address - Street 1:1101 MADISON ST STE 600
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1340
Practice Address - Country:US
Practice Address - Phone:206-215-2020
Practice Address - Fax:206-215-2022
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-19
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO185372207W00000X
WAOP60973150207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2141892Medicaid