Provider Demographics
NPI:1033980628
Name:SHEVCHENKO, VERA A (ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:A
Last Name:SHEVCHENKO
Suffix:
Gender:F
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 E WAHOO RD
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-9767
Mailing Address - Country:US
Mailing Address - Phone:503-867-0143
Mailing Address - Fax:
Practice Address - Street 1:759 E HOLLAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1257
Practice Address - Country:US
Practice Address - Phone:509-270-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61509782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily