Healthcare Provider Details

I. General information

NPI: 1174801328
Provider Name (Legal Business Name): KAI LINSAY SHARBONO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 W CATALDO AVE FL 3
SPOKANE WA
99201-2217
US

IV. Provider business mailing address

PO BOX 421
LIBERTY LAKE WA
99019-0421
US

V. Phone/Fax

Practice location:
  • Phone: 509-747-6194
  • Fax: 509-838-0824
Mailing address:
  • Phone: 866-747-2455
  • Fax: 509-277-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberRL 12000
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD607602
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number303044
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: