Individual provider Active NPI

Shayna Rose Waldbaum, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1003442898
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD70022393 Issued in WA
Practice address
4100 SW Alaska St Ste B
Seattle, WA 98116-4527
Phone
(206) 320-3399
NPI assigned
Mar 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD70022393 WA Primary

Addresses

Primary practice location

4100 SW Alaska St Ste B
Seattle, WA 98116-4527

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-3399

Other identifiers 1

IdentifierTypeStateIssuer
2181992MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251028000188 WA Practitioner - Family Practice 3072916998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

4100 SW Alaska St
Suite B
Seattle, WA 98116-4527
Phone (206) 320-3399

Hospital & facility affiliations

  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027
  • Swedish Medical Center / Cherry Hill Hospital, Seattle, WA, CCN 500025

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD70022393WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Family Medicine CurrentSince Oct 6, 2025 Accepting new patients
Swedish Health Services CurrentSince Oct 6, 2025 Accepting new patients
Swedish Health Services Family Medicine Current Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

4100 SW Alaska St
#B
Seattle, WA 98116
Phone (206) 320-3399

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

Interoperability endpoints

  • Direct secure messaging: swaldbaum1408509@wm.providencedirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1003442898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 SW ALASKA ST STE B",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164527",
            "telephone_number": "206-320-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDBAUM",
        "first_name": "SHAYNA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD70022393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2181992",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.