Basic Information
Provider Information
NPI: 1023211273
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHORR
FirstName: RACHEL
MiddleName: BRINN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 312 HARVARD AVE E
Address2:  
City: SEATTLE
State: WA
PostalCode: 981026023
CountryCode: US
TelephoneNumber: 2063515051
FaxNumber:  
Practice Location
Address1: SWEDISH FAMILY MEDICINE RESIDENCY PROGRAM
Address2: 550 16TH AVE SUITE #100
City: SEATTLE
State: WA
PostalCode: 98122
CountryCode: US
TelephoneNumber: 2063202233
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/06/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XML20008345WAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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