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Contact Information

SHANE O BROOKS, DO
450 S KITSAP BLVD
#100
PORT ORCHARD, WA98366-3773
 Phone: 360-744-6275
 Fax: 360-895-6296
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for SHANE O BROOKS · (Male)

NPI # 1154364115
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 06/14/2006
Last updated 12/13/2010 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • WA License # OP00001839
  • WA Medicaid 8326985
  • WA Other BSWA 2264BR
  • WA Other 1594BR BSWA
  • WA Other 2165BR BSWA
  • WA Other 0171367 LIWA
  • WA Other 0181442 LIWA
Hospital affiliation(s)
  • TACOMA GENERAL ALLENMORE HOSPITAL - (Acute Care)
    315 S MLK JR WAY
    TACOMA, WA 98415
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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