Healthcare Provider Details

I. General information

NPI: 1184853483
Provider Name (Legal Business Name): VAISHALI SHAH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NE MOTHER JOSEPH PL
VANCOUVER WA
98664-3200
US

IV. Provider business mailing address

1 BARNES JEWISH HOSPITAL PLZ 4TH FLOOR, RENARD BUILDING
SAINT LOUIS MO
63110-1003
US

V. Phone/Fax

Practice location:
  • Phone: 360-696-5232
  • Fax:
Mailing address:
  • Phone: 832-279-7060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD60821189
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2009010819
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: