Provider Demographics
NPI:1346233491
Name:SHEPARD, KAREN E (DC)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:E
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13400 NE 20TH ST STE#8
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005
Mailing Address - Country:US
Mailing Address - Phone:425-641-2822
Mailing Address - Fax:866-922-2457
Practice Address - Street 1:13400 NE 20TH ST STE 8
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2026
Practice Address - Country:US
Practice Address - Phone:425-641-2822
Practice Address - Fax:866-922-2457
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003597111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0126295OtherLABOR & INDUSTRIES
WA8423329Medicaid
SH7831OtherREGENCE BLUE SHIELD
192264900OtherFEDERAL WORKER'S COMP
U76050Medicare UPIN
GAB09919Medicare ID - Type Unspecified