SHANNON URSULA WATERMAN (NPI# 1649279860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649279860 |
| Entity Type | Individual |
| Full Name | SHANNON URSULA WATERMAN |
| Credential | MD |
| Practice Address |
11225 Pacific Avenue Parkland Clinic Community Healthcare Tacoma WA 98444 |
| Mailing Address |
101 E 26th Street Tacoma WA 98421 |
| Practice Telephone | 2535362020 |
| Practice Fax Number | 2535365327 |
| Mailing Telephone | 2537221540 |
| Mailing Fax Number | 2537221546 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2009-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 025209MD00041909 | WA | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | MD00041919 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8505422 | 05 | |
| MEDICARE RAILROAD | P00707652 | 01 | |
| NM | 41383885 | 05 |
| Street Address |
11225 PACIFIC AVENUE PARKLAND CLINIC COMMUNITY HEALTHCARE |
| City | TACOMA |
| State | WA |
| Zip Code | 98444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033344791 | Carri Jo Timmer | Family Medicine | 11225 Pacific Avenue, Parkland Clinic, Tacoma, WA 98444 | 2009-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356820039 | Reuben Edward Robinson | Massage Therapist | 10603 16th Avenue Ct S Apt 8, Tacoma, WA 98444 | 2018-08-13 |
| 1720507601 | Jayna Marie Owens | Counselor | 14016 A Street South, Tacoma, WA 98444 | 2017-09-12 |
| 1578011425 | Kyleigh Harlow | Dietitian, Registered | 11011 Park Ave S, C212, Tacoma, WA 98444 | 2016-09-20 |
| 1104220565 | Kehau Tester | Specialist | 9020 A Street, Tacoma, WA 98444 | 2014-10-14 |
| 1669874061 | Andrea Dawn Mckamey | Massage Therapist | 101 138th St. E., 28, Tacoma, WA 98444 | 2014-09-17 |
| 1841609666 | Marci Oswald | Dental Hygienist | 130 131st Street South, Tacoma, WA 98444 | 2014-08-06 |
| 1841611829 | Lucas Victor Briggs | Physical Therapist | 223 140th St. South Suite # 700, Elite Physical Therapy, Tawma, WA 98444 | 2013-12-18 |
| 1457798092 | Dent Korsmo & Henry D.d.s., P.s. | Dentist | 12165 Pacific Ave, Suite A, Tacoma, WA 98444 | 2013-05-22 |
| 1740521566 | Kristine-cassandra B. Papa | Massage Therapist | 10202 Pacific Ave. S, Suite 215, Tacoma, WA 98444 | 2013-03-04 |
| 1356687941 | Matthew Hockin | Dentist | 223 140th Street South, Suite 800, Tacoma, WA 98444 | 2012-12-31 |
| Find all providers in zip 98444 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255896601 | Emily Christine Buck | General Practice | 940 Fitzsimmons Dr, Tacoma, WA 98431-0001 | 2019-02-08 |
| 1457708430 | James Bailey | General Practice | 9040 Jackson Ave Tripler Army Medical Center, Tacoma, WA 98431-5001 | 2016-05-19 |
| 1841553740 | Nevine F N Makari | General Practice | 6909 Bridgland Ln, Tacoma, WA 98407-1020 | 2012-06-17 |
| 1952637332 | Proctor Medical Clinic | General Practice | 1208 South Proctor St, Tacoma, WA 98405 | 2009-10-20 |
| 1194050773 | K and A Diagnostic Center | General Practice | 1206 South Proctor St, Tacoma, WA 98405 | 2009-10-15 |
| 1811915374 | Dung Xuan Nguyen | General Practice | 3736 S G St, Tacoma, WA 98418-6725 | 2006-07-17 |
| 1770514937 | Spanaway General Medical Clinic | General Practice | 15005 Pacific Ave, Spanaway General Medical Clinic, Tacoma, WA 98444 | 2006-07-06 |
| 1710936208 | Jane Ann Moore | General Practice | 6002 Westgate Blvd, Suite 160, Tacoma, WA 98406-2571 | 2006-05-10 |
| 1295716884 | Thu Van Le | General Practice | 1212 S 11th St, Suite 39, Tacoma, WA 98405-4021 | 2005-11-10 |
| 1841750536 | Clayton Andrew Harris | General Practice | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-03-20 |
| Find all providers in TACOMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.