Healthcare Provider Details

I. General information

NPI: 1376733709
Provider Name (Legal Business Name): SHAWN RYAN COTTRELL O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7913 ALLISON WAY STE 102
ARVADA CO
80005-4450
US

IV. Provider business mailing address

7913 ALLISON WAY STE 102
ARVADA CO
80005-4450
US

V. Phone/Fax

Practice location:
  • Phone: 303-424-5282
  • Fax: 303-424-8291
Mailing address:
  • Phone: 303-424-5282
  • Fax: 303-424-8291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2601
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: