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General NPI Number Information
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NPI Number | 1225480411
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Entity Type | Individual
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Provider Name | OTTO SHILL DO
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Gender | Male
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 12810 E NORA AVE STE F
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-1055
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Country | US
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Telephone | 509-303-4001
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Fax | 509-286-1354
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Provider Business Mailing Address
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Address Line | 12810 E NORA AVE STE F
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-1055
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Country | US
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Telephone | 509-303-4001
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Fax | 509-286-1354
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OP60842403
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RB0002X
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Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
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License Number | OP60842403
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License Number State | WA
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