Individual provider Active NPI

Shahlan T Alraddawi, MD

  • Internal Medicine Physician
  • Seattle, WA
National Provider Identifier
1477181212
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD61439940 Issued in WA
Practice address
6322 Roosevelt Way NE
Seattle, WA 98115-6625
Phone
(206) 320-8050
Fax
(206) 320-8048
NPI assigned
Mar 28, 2020
Last updated
Nov 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD61439940 WA Primary
Internal Medicine Physician 207R00000X A197476 CA

Addresses

Primary practice location

6322 Roosevelt Way NE
Seattle, WA 98115-6625

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
20231107652109MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250424003645 CA Practitioner - Internal Medicine 4082060868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

1100 Las Tablas Rd
Templeton, CA 93465-9704
Phone (805) 434-3500

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone (310) 829-5511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A197476CAMDInternal Medicine Physician
MD61439940WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians PC CurrentSince Nov 14, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 14, 2025 Accepting new patients
Galen Inpatient Physicians, PC Current Accepting new patients
Providence Saint Johns Medical Foundation Internal Medicine CurrentSince Sep 2, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Galen Inpatient Physicians PC CurrentSince Nov 14, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 14, 2025 Accepting new patients
Saint John's Health Clinic Past Accepting new patients
Swedish Health Services Internal Medicine Past Accepting new patients

Locations

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

1010 Murray Ave
Sn Luis Obisp, CA 93405
Phone (805) 546-7600

1100 Las Tablas Rd
Templeton, CA 93465
Phone (805) 434-3500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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

Hospital & facility affiliations 3

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": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1477181212",
    "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": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6322 ROOSEVELT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981156625",
            "telephone_number": "206-320-8050",
            "fax_number": "206-320-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALRADDAWI",
        "first_name": "SHAHLAN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-28",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61439940",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A197476",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20231107652109",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.