Provider Demographics
NPI:1376770057
Name:CHANDON-COOKE, SHONA TREASHANA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SHONA
Middle Name:TREASHANA
Last Name:CHANDON-COOKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:SHONA
Other - Middle Name:
Other - Last Name:CHANDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:5309 9TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-2901
Mailing Address - Country:US
Mailing Address - Phone:202-802-2844
Mailing Address - Fax:
Practice Address - Street 1:1310 SOUTHERN AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4623
Practice Address - Country:US
Practice Address - Phone:202-574-6545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA030604363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical