Healthcare Provider Details

I. General information

NPI: 1437923158
Provider Name (Legal Business Name): SHELLY DONOVAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 07/02/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 SOUTH FERRALL STREET
SPOKANE WA
99202
US

IV. Provider business mailing address

3105 E BOONE AVE
SPOKANE WA
99202-3607
US

V. Phone/Fax

Practice location:
  • Phone: 509-906-1527
  • Fax:
Mailing address:
  • Phone: 509-906-1527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: