Healthcare Provider Details

I. General information

NPI: 1932707411
Provider Name (Legal Business Name): SHELBY SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2020
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 E 29TH AVE
SPOKANE WA
99203-3917
US

IV. Provider business mailing address

9707 N SUNDANCE DR
SPOKANE WA
99208-9351
US

V. Phone/Fax

Practice location:
  • Phone: 509-252-1366
  • Fax:
Mailing address:
  • Phone: 509-434-8745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number61271489
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: