SHANNON U. WATERMAN MD – NPI #1649279860
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

SHANNON WATERMAN is a physician located in TACOMA, WA. NPPES has assigned the NPI number 1649279860 to SHANNON WATERMAN on July 19, 2005. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was previously updated about 17 years ago on Aug 05, 2009. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SHANNON WATERMAN below.

NPI Profile for
SHANNON U. WATERMAN

NPI Number
1649279860
Enumeration Date

(about 21 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
SHANNON U. WATERMAN
Credentials
MD
Primary location
11225 PACIFIC AVENUE
PARKLAND CLINIC COMMUNITY HEALTHCARE
TACOMA, WA 98444
Phone: (253) 536-2020 Fax: (253) 536-5327
Mailing address
101 E 26TH STREET
TACOMA, WA 98421
Phone: (253) 722-1540 Fax: (253) 722-1546
Sole Proprietor
No
Updated
Identifiers

Identifiers for SHANNON WATERMAN

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERMEDICARE RAILROADP00707652
MEDICAIDNM41383885
MEDICAIDWA8505422
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)
WA MD00041919
208600000X
- Surgery
WA 025209MD00041909

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.