Provider Demographics
NPI:1750758504
Name:SHIREY, ERIC (RN)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SHIREY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 5TH AVE
Mailing Address - Street 2:MAILSTOP KCJ-PH-0600
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2332
Mailing Address - Country:US
Mailing Address - Phone:206-477-2293
Mailing Address - Fax:206-296-0579
Practice Address - Street 1:500 5TH AVE
Practice Address - Street 2:MAILSTOP KCJ-PH-0600
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2332
Practice Address - Country:US
Practice Address - Phone:206-477-2293
Practice Address - Fax:206-296-0579
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00099528163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health