Provider Demographics
NPI:1144625542
Name:MOORE, SHANNA MARIE (MSN, RN, FNP-C)
Entity type:Individual
Prefix:
First Name:SHANNA
Middle Name:MARIE
Last Name:MOORE
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:17908 N SADDLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-9347
Mailing Address - Country:US
Mailing Address - Phone:509-890-3901
Mailing Address - Fax:
Practice Address - Street 1:318 E ROWAN AVE STE 201
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1200
Practice Address - Country:US
Practice Address - Phone:509-275-8600
Practice Address - Fax:509-275-2333
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2025-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP126728363LF0000X
MTAPRN-131649363LF0000X
OR10001135363LF0000X
ID59453363LF0000X
WAAP60889399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily