Anderson, Shane Selassie
Anderson, Shane Selassie is an individual health care provider with primary practice located at 1001 Sw Klickitat Way 205, Seattle WA 98134-1161. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Anderson, Shane Selassie can be contacted via phone (206) 622-7747.Contact Information
Primary practice address
1001 Sw Klickitat Way 205
Seattle WA 98134-1161
Phone: (206) 622-7747
Fax: (206) 467-1470
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 79786 | Arizona |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ZD0900X | MD00039332 | Washington |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD00039332 | Washington |
Profile Details
| NPI number | 1952383432 |
|---|---|
| LBN Legal business name | Anderson, Shane Selassie |
| Credentials | MD PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 18th, 2005 |
| Last updated | Feb 26th, 2026 - about 8 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952383432 | NPPES |
| Washington | MEDICAID | 8416026 | |
| Washington | Other | 142146 |
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