Provider Demographics
NPI:1487453080
Name:MCSHANE, ISLA GRACE
Entity type:Individual
Prefix:
First Name:ISLA
Middle Name:GRACE
Last Name:MCSHANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 NW 54TH ST STE 426
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3561
Mailing Address - Country:US
Mailing Address - Phone:206-672-1130
Mailing Address - Fax:
Practice Address - Street 1:1417 NW 54TH ST STE 426
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3561
Practice Address - Country:US
Practice Address - Phone:708-263-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician