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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SHANNON TILLERY MD
NPI 1235874975
Psychiatry & Neurology - Psychiatry in Seattle, WA

Active since April 27, 2022Opted out of Medicare · through Jun 26, 2028
1417 NW 54TH ST STE 350, SEATTLE, WA 98107(206) 401-5681(206) 970-2608 Get Directions Write a Review

NPPES record last updated: September 7, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Sep 7, 2026, Aug 20, 2026, Jul 13, 2026 and 1 more (4 updates tracked since 2022).

About Shannon Tillery Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON TILLERY MD (NPI 1235874975) is an individual psychiatry provider in Seattle, Washington, licensed in Washington (MD70019274) and active in the NPI registry since April 2022. She has opted out of Medicare through June 26, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1235874975
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameSHANNON TILLERYCredential: MD
Location Address1417 NW 54TH ST STE 350Seattle, WA 98107-3575
Mailing Address1417 Nw 54th St Ste 350Seattle, WA 98107-3575
Phone(206) 401-5681
Fax(206) 970-2608
Sole ProprietorNo
Enumeration DateApril 27, 2022
Last NPPES UpdateSeptember 7, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 7, 2026
✔ NPI 1235874975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in WA · MD70019274
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1417 NW 54TH ST STE 350, Seattle, WA 98107
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Shannon Tillery Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 26, 2026 through June 26, 2028.

Opt-Out Effective DateJune 26, 2026
Opt-Out In Effect ThroughJune 26, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$189.37 typical visit price
range $63.67 – $189.37
Typical copayment $47.34 (range $15.91 – $47.34)
Most-billed visit code 99205
Established Patient
$78.74 typical visit price
range $21.12 – $155.00
Typical copayment $19.68 (range $5.28 – $38.75)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Tillery's NPI number?

The NPI number for Shannon Tillery is 1235874975. It was assigned to this individual provider in the NPPES registry on April 27, 2022.

Where is Shannon Tillery located?

Shannon Tillery practices at 1417 NW 54th St Ste 350, Seattle, WA 98107. The listed phone number is (206) 401-5681.

What is Shannon Tillery's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Shannon Tillery enrolled in Medicare?

No. Shannon Tillery has opted out of Medicare through June 26, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Shannon Tillery was last updated on September 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.