Provider Demographics
NPI:1982648465
Name:SHUSTER, PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SHUSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16122 8TH AVE SW STE E5
Mailing Address - Street 2:STE E-5
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2967
Mailing Address - Country:US
Mailing Address - Phone:206-241-0824
Mailing Address - Fax:206-243-8002
Practice Address - Street 1:16122 8TH AVE SW
Practice Address - Street 2:STE E-5
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2967
Practice Address - Country:US
Practice Address - Phone:206-241-0824
Practice Address - Fax:206-243-8002
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00029701207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA310616OtherSTATE L&I
WA310616OtherSTATE L&I
WAG8922437Medicare PIN