Fernando, Shanik J
Fernando, Shanik J is an individual health care provider with primary practice located at 104 27Th Ave Se , Puyallup WA 98374-1145. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otology & Neurotology, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Fernando, Shanik J can be contacted via phone (253) 770-9000.Contact Information
Primary practice address
104 27Th Ave Se
Puyallup WA 98374-1145
Phone: (253) 770-9000
Fax: (253) 770-9712
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otology & Neurotology | 207YX0901X | MD.MD.70129110 | Washington |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | MD.MD.70129110 | Washington |
Profile Details
| NPI number | 1538514179 |
|---|---|
| LBN Legal business name | Fernando, Shanik J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2016 |
| Last updated | Aug 28th, 2026 - about 2 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 | 1538514179 | NPPES |
| Washington | MEDICAID | 2221843 |
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