Shane Selassie Anderson (NPI# 1952383432, PAC ID# 7911950688) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PATHOLOGY.
| Nation Provider ID (NPI) | 1952383432 |
| PAC ID by PECOS | 7911950688 |
| Professional Enrollment ID | I20050223000348 |
| Full Name | Shane Selassie Anderson |
| Organization Legal Name | SURGICAL ASSOCIATES NORTHWEST PC |
| Address |
202 Division St N Suite 100 Auburn WA 98001-4939 |
| Phone Number | 2538333555 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MINNESOTA MEDICAL SCHOOL |
| Graduation Year | 1996 |
| Primary Specialty | PATHOLOGY |
| Group Practice PAC ID | 3971596024 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 500124 | EVERGREEN HOSPITAL MEDICAL CENTER |
| 500141 | ST FRANCIS COMMUNITY HOSPITAL |
| 500011 | HIGHLINE MEDICAL CENTER |
| 500039 | HARRISON MEDICAL CENTER |
| 500108 | ST JOSEPH MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 202 Division St N, Suite 100, Auburn, WA 98001-4939 | 2538333555 | SURGICAL ASSOCIATES NORTHWEST PC |
| 34612 6th Ave S, Federal Way, WA 98003-8723 | SURGICAL ASSOCIATES NORTHWEST PC | |
| 1124 Columbia St, Suite 200, Seattle, WA 98104-2048 | 2063862676 | CELLNETIX PATHOLOGY PLLC |
| Organization Legal Name | SURGICAL ASSOCIATES NORTHWEST PC |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony P Caruso | Urology | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Ryan E Stern | Otolaryngology | Surgical Associates Northwest PC | 34612 6th Ave S, Suite 210, Federal Way, WA 98003-8723 |
| Yi C Hsieh | Urology | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Ken Haberman | Urology | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Nancy K Renne | Qualified Audiologist | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Kirby J Lautman | Otolaryngology | Surgical Associates Northwest PC | 34612 6th Ave S, Suite 210, Federal Way, WA 98003-8723 |
| Mark B Emery | Otolaryngology | Surgical Associates Northwest PC | 34612 6th Ave S, Suite 210, Federal Way, WA 98003-8723 |
| Mark D Hegewald | Otolaryngology | Surgical Associates Northwest PC | 34612 6th Ave S, Suite 210, Federal Way, WA 98003-8723 |
| Kevin J Ward | Urology | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Stephen H King | Urology | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Street Address |
202 DIVISION ST N SUITE 100 |
| City | AUBURN |
| State | WA |
| Zip | 98001-4939 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony P Caruso | Urology | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Yi C Hsieh | Urology | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Ken Haberman | Urology | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Nancy K Renne | Qualified Audiologist | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Kevin J Ward | Urology | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Stephen H King | Urology | Surgical Associates Northwest PC | 202 Division St N, Suite 100, Auburn, WA 98001-4939 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David H Poole | Chiropractic | 3820 S, 320th, Auburn, WA 98001-3115 | |
| Edwin S Chin | Nephrology | 121 N Division St, Suite 340, Auburn, WA 98001-4931 | |
| Mark Hsueh Tseng | General Surgery | 121 N Division St, Suite 310, Auburn, WA 98001-4931 | |
| Anthony S Stephens | Nurse Practitioner | Multicare Health System | 202 N Division St, Auburn, WA 98001-4939 |
| Michael R Nelsen | Diagnostic Radiology | Vantage Radiology and Diagnostic Services, A Professional Services Cor | 202 N Division St Plaza One, Auburn Reg Med Ctr, Auburn, WA 98001-4939 |
| Martin M.t. Lee | Critical Care (intensivists) | Multicare Health System | 202 N Division St, Auburn, WA 98001-4939 |
| Sidney N Beers | Emergency Medicine | Cascade Emergency Physicians Inc | 202 N Division St, Auburn, WA 98001-4939 |
| Tariq Salam | Cardiac Electrophysiology | Multicare Health System | 202 N Division St, Auburn, WA 98001-4939 |
| Richard S Mcmonigal | Emergency Medicine | Cascade Emergency Physicians Inc | 202 N Division St, Auburn, WA 98001-4939 |
| Albert C Morriss | Physician Assistant | Washington Gastroenterology Pllc | 202 N Division St, Auburn, WA 98001-4939 |
| Find all physicians in zip 98001 | |||
| City | AUBURN |
| Zip Code | 98001 |
| Specialty | PATHOLOGY |
| City + Specialty | AUBURN + PATHOLOGY |
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| 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.