Healthcare Provider Details

I. General information

NPI: 1386614030
Provider Name (Legal Business Name): ABIGAIL K. SHOQUIST PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ARMY MEDICAL CTR 9040A JACKSON AVE
TACOMA WA
98431-0001
US

IV. Provider business mailing address

MADIGAN ARMY MEDICAL CENTER 9040A JACKSON AVE
TACOMA WA
98431-1100
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-2700
  • Fax: 253-968-3731
Mailing address:
  • Phone: 253-968-5906
  • Fax: 253-968-4489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY 00003847
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: