Amanda Shim
General Practice in Tacoma, WA. Individual provider (NPI-1).
NPI number1003671041
StatusActive
Last updated in NPPESSep 16, 2025
Details
- NPI
- 1003671041
- Entity type
- Individual (NPI-1)
- Name
- Amanda Shim
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 19, 2024
- Certification date
- Sep 16, 2025
- Last updated
- Sep 16, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - EMERGENCY MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | 0101286930 | VA | Yes |
Practice location
9040 Jackson AveTacoma, WA 98431-0001
Phone 253-968-1250
Mailing address
9040 Jackson AveTacoma, WA 98431-0001
Phone 253-968-1250
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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