Healthcare Provider Details

I. General information

NPI: 1851678304
Provider Name (Legal Business Name): SHELLEY MAUREED WARNICK HENGESH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2011
Last Update Date: 11/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 N LINCOLN ST SUITE B
SPOKANE WA
99201-2138
US

IV. Provider business mailing address

1105 N LINCOLN ST SUITE B
SPOKANE WA
99201-2138
US

V. Phone/Fax

Practice location:
  • Phone: 509-252-9891
  • Fax: 509-838-7503
Mailing address:
  • Phone: 509-252-9891
  • Fax: 509-838-7503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: