| Doctor Name: | SHANNON PENDLETON |
| NPI Number: | 1265866313 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | APRN-1615 |
| Business Practice Address: | 3021 Griffin Ave Enumclaw, WA - 980222369 |
| Business Phone Number: | 3608256511 |
| Business Fax Number: | 3608256536 |
| Mailing Address: | 3021 Griffin Ave, ENUMCLAW |
| State: | WA |
| Postal Code: | 980222369 |
| Phone Number: | 3608256511 |
| Fax Number: | 3608256536 |
| NPI Enumeration Date: | 08/26/2013 |
| NPI Last Update Date: | 11/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APRN-1615 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | HI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |