Individual provider Active NPI

Shannah Marie Hewitt, M.D.

  • Family Medicine Physician
  • Shoreline, WA
National Provider Identifier
1053522284
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60014633 Issued in WA
Practice address
1201 N 175TH St
Shoreline, WA 98133-5064
Phone
(206) 401-3156
Fax
(206) 401-3201
NPI assigned
May 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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 MD60014633 WA Primary

Addresses

Primary practice location

1201 N 175TH St
Shoreline, WA 98133-5064

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other identifiers 1

IdentifierTypeStateIssuer
2013747MedicaidWA

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
I20110825000129 WA Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 2163569674 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
University of Cincinnati College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

1201 N 175TH St
Shoreline, WA 98133-5064
Phone (425) 339-4299

Hospital & facility affiliations

  • Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60014633WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Family Medicine CurrentSince Sep 23, 2024 Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince Sep 23, 2024 Accepting new patients
Optum Care Washington PLLC CurrentSince Sep 23, 2024 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

209 Moller Ave
Sitka, AK 99835
Phone (907) 747-1722

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

1145 Broadway
Seattle, WA 98122

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: shewitt15542@direct.tecmc.com

Organizations & group practices 5

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": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1053522284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N 175TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335064",
            "telephone_number": "206-401-3156",
            "fax_number": "206-401-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEWITT",
        "first_name": "SHANNAH",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-28",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60014633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2013747",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

Verify at the official NPI Registry.