Healthcare Provider Details

I. General information

NPI: 1407506975
Provider Name (Legal Business Name): SHERIDAN JOSEPH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2022
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 N HUTCHINSON RD
SPOKANE VALLEY WA
99212-2444
US

IV. Provider business mailing address

1807 N HUTCHINSON RD
SPOKANE VALLEY WA
99212-2444
US

V. Phone/Fax

Practice location:
  • Phone: 509-456-7414
  • Fax: 509-624-0763
Mailing address:
  • Phone: 509-456-7414
  • Fax: 509-624-0763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number8981406
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD70115869
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: