Shane R Son


Address: 404 Black Hills Lane Sw, Suite D, Olympia, WA 98502

Shane R Son (NPI# 1225180698, PAC ID# 6305809856) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.

Physician Overview

Nation Provider ID (NPI) 1225180698
PAC ID by PECOS 6305809856
Professional Enrollment ID I20041105000881
Full Name Shane R Son
Address 404 Black Hills Lane Sw
Suite D
Olympia
WA 98502
Gender M
Credential MD
Graduation Year 1988
Primary Specialty FAMILY MEDICINE
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
500139 CAPITAL MEDICAL CENTER
501336 MASON GENERAL HOSPITAL & FAMILY OF CLINICS
500024 PROVIDENCE ST PETER HOSPITAL

Other Locations

Address Phone Organization
404 Black Hills Lane Sw, Suite D, Olympia, WA 98502

Organization Information

Office Location

Street Address 404 BLACK HILLS LANE SW
SUITE D
City OLYMPIA
State WA
Zip 98502

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Nancy Jane Sullivan Clinical Social Worker 1800 Cooper Point Sw Rd, 24b, Olympia, WA 98502-1039
Suzan I Kudick Chiropractic 1800 Cooper Point Rd Sw, Suite 24a, Olympia, WA 98502-1039
Harrison E Williams Physical Therapy Steamboat Physical Therapy, Inc. 2102 Carriage Dr Sw, Suite B, Olympia, WA 98502-1049
Kristyn M Schlenker Physical Therapy Steamboat Physical Therapy, Inc. 2102 Carriage Dr Sw B, Olympia, WA 98502-1049
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Andrea D Gallo Physical Therapy Steamboat Physical Therapy, Inc. 2102 Carriage Dr Sw, Suite B, Olympia, WA 98502-1049
Jennifer G Zoller Physical Therapy Steamboat Physical Therapy, Inc. 2102 Carriage Dr Sw, Suite B, Olympia, WA 98502-1049
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Competitor

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City OLYMPIA
Zip Code 98502
Specialty FAMILY MEDICINE
City + Specialty OLYMPIA + FAMILY MEDICINE

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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