Shultis, Michael Severin

Shultis, Michael Severin is an individual health care provider with primary practice located at 111 S 11Th Ave Ste 320 , Yakima WA 98902-3273. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Shultis, Michael Severin can be contacted via phone (509) 454-8888.

Contact Information

Primary practice address
111 S 11Th Ave Ste 320 Yakima WA 98902-3273
Phone: (509) 454-8888
Fax: (509) 453-0061
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA60205742 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60205742 Washington

Profile Details

NPI number 1013154038
LBN Legal business name Shultis, Michael Severin
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2009
Last updated Jan 26th, 2023 - about 2 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 1013154038 NPPES
Washington MEDICAID 2011328

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