Healthcare Provider Details

I. General information

NPI: 1457694390
Provider Name (Legal Business Name): SHELBY APODACA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHELBY CLEMENTS

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W 5TH AVE STE 300
SPOKANE WA
99204-2972
US

IV. Provider business mailing address

2003 KOOTENAI HEALTH WAY
COEUR D ALENE ID
83814-6051
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-2531
  • Fax: 509-755-6580
Mailing address:
  • Phone: 208-625-3961
  • Fax: 208-625-6790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD60721548
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberM-15201
License Number StateID
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberM15201
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: