Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shannon Slack

Individual provider Nurse Practitioner · NPI 1790161222

Shannon Slack is a Nurse Practitioner in Olympia, Washington. Licensed in Washington. Registered with an NPI since 2015.

Licensed in
WA
In the registry since
2015

Practice location Address checks out

2000 Lakeridge Dr SW
Olympia, WA 98502-6001
Phone: (360) 754-2941
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence AP60571003 (WA)

Record details

NPI number1790161222
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 6, 2015
Last updated in NPPESApril 19, 2017
Mailing address9039 Silverspot Dr Se, Tumwater, WA 98501-5575

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