Healthcare Provider Details

I. General information

NPI: 1093075103
Provider Name (Legal Business Name): SARAH LOUISE SHOGREN DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 E HOLLAND AVE STE 112
SPOKANE WA
99218-1246
US

IV. Provider business mailing address

605 E HOLLAND AVE STE 112
SPOKANE WA
99218-1246
US

V. Phone/Fax

Practice location:
  • Phone: 509-342-3251
  • Fax: 509-342-3280
Mailing address:
  • Phone: 509-342-3251
  • Fax: 509-342-3280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPL60162079
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: