Shockley, Courtney

Shockley, Courtney is an individual health care provider with primary practice located at 1806 W Lincoln Ave , Yakima WA 98902-2473. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Shockley, Courtney can be contacted via phone (509) 452-4520.

Contact Information

Primary practice address
1806 W Lincoln Ave Yakima WA 98902-2473
Fax: (509) 452-5224
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD60578513 Washington

Profile Details

NPI number 1558656314
LBN Legal business name Shockley, Courtney
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2011
Last updated Feb 5th, 2019 - about 7 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558656314 NPPES
Washington MEDICAID 2047300

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