Basic Information
| Provider Information | |||||||||
| NPI: | 1033582663 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PILLE | ||||||||
| FirstName: | SUNSHINE | ||||||||
| MiddleName: | A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4311 11TH AVE NE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981056366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2066164001 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4311 11TH AVE NE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981056366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2066164001 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2015 | ||||||||
| LastUpdateDate: | 12/06/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA60703251 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | PA60703251 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 363AS0400X | PA60703251 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.