Shannon Tillery, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD70019274 Issued in WA

Practice address

1417 NW 54TH St Ste 350
Seattle, WA 98107-3575

Phone

(206) 401-5681

Fax

(206) 970-2608

NPI assigned

Apr 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 26, 2026 through Jun 26, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788739200000",
    "number": "1235874975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 NW 54TH ST STE 350",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 NW 54TH ST STE 350",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073575",
            "telephone_number": "206-401-5681",
            "fax_number": "206-970-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "SHANNON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD70019274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Tilden, ARNP
• David Tilford, RN
• Tilia Natural Health
• Brian Gerald Till, MD
• Adriane R. Tillery, RC
• Sasha Wynn Tilles
• Stephen Tilles, M.D.
• London Tillinghast
• Landi M Tillis
• Tillman Family Chiropractic, Inc., P.S.

• Psychiatry Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.