Healthcare Provider Details

I. General information

NPI: 1972372902
Provider Name (Legal Business Name): SHARAYA HUNDEBY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARAYA SIMONS

II. Dates (important events)

Enumeration Date: 01/02/2024
Last Update Date: 10/20/2026
Certification Date: 10/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 ONTARIO ST
SANDPOINT ID
83864-1786
US

IV. Provider business mailing address

1555 ONTARIO ST
SANDPOINT ID
83864-1786
US

V. Phone/Fax

Practice location:
  • Phone: 209-597-7910
  • Fax:
Mailing address:
  • Phone: 208-597-7910
  • Fax: 509-227-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61502490
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: