Timothy Patrick Shannon, BSN, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN61217405 Issued in WA

Practice address

9245 Rainier Ave S
Seattle, WA 98118-5569

Phone

(206) 612-2866

NPI assigned

May 1, 2017

Reactivated

Feb 8, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1730614579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 15TH AVE NE APT 406",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056249",
            "telephone_number": "206-612-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981185569",
            "telephone_number": "206-612-2866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "TIMOTHY",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "BSN, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "deactivation_date": "2024-02-01",
        "reactivation_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "WA",
            "license": "PC60752642",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61217405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Shannon, PA-C
• Jordan Patrick Shannon, PHD, LMHCA, NCC
• Margaret Shannon, LMHC
• Michael Brendan Shannon, M.D.
• Michael Caroll Shannon, MD
• Nathan Shapiro-Shellaby, CRNA
• Adrienne E Shapiro, MD, PHD
• Deborah Carol Shapiro, PSY.D
• Emily Jeanne Shapiro
• Joel A Shapiro, M.D.

• Registered Nurse in Seattle, WA
• Providers in Seattle, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.