Provider Demographics
NPI:1780982694
Name:NEWELL, SHIRLEY (MD)
Entity type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:
Last Name:NEWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHIRLEY
Other - Middle Name:
Other - Last Name:BROMBERG-NEWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1126 38TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4434
Mailing Address - Country:US
Mailing Address - Phone:206-390-0887
Mailing Address - Fax:206-322-9766
Practice Address - Street 1:1126 38TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4434
Practice Address - Country:US
Practice Address - Phone:206-390-0887
Practice Address - Fax:206-322-9766
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 00022218207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine