Healthcare Provider Details

I. General information

NPI: 1457109746
Provider Name (Legal Business Name): SHANNON VALENTINE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15812 E INDIANA AVE
SPOKANE VALLEY WA
99216-1875
US

IV. Provider business mailing address

611 N IRON BRIDGE WAY
SPOKANE WA
99202-4932
US

V. Phone/Fax

Practice location:
  • Phone: 509-444-8200
  • Fax: 509-434-0392
Mailing address:
  • Phone: 509-444-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61562880
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60673271
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: