Provider Demographics
NPI:1053654913
Name:SHOEMAKER, PAUL A (ARNP)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:SHOEMAKER
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-8931
Mailing Address - Country:US
Mailing Address - Phone:509-837-0070
Mailing Address - Fax:509-837-0690
Practice Address - Street 1:2935 ALLEN RD
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-8931
Practice Address - Country:US
Practice Address - Phone:509-837-0070
Practice Address - Fax:509-837-0690
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60089738163W00000X
WAAP60896880363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse