Provider Demographics
NPI:1457975948
Name:HURST AND SHANNON PLLC
Entity Type:Organization
Organization Name:HURST AND SHANNON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:844-295-6915
Mailing Address - Street 1:400 PINE ST STE 2017
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 PINE ST STE 2017
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-3625
Practice Address - Country:US
Practice Address - Phone:844-295-6915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty