Healthcare Provider Details

I. General information

NPI: 1770491995
Provider Name (Legal Business Name): SHAUN PARRISH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 N VERCLER RD
SPOKANE VALLEY WA
99216-1020
US

IV. Provider business mailing address

14918 E CROWN AVE
SPOKANE VALLEY WA
99216-3049
US

V. Phone/Fax

Practice location:
  • Phone: 509-228-1000
  • Fax:
Mailing address:
  • Phone: 310-341-6181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP70177099-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: