Provider Demographics
NPI:1396862868
Name:SHOHAM, ALLEN B (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:B
Last Name:SHOHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 SWIFT BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3513
Mailing Address - Country:US
Mailing Address - Phone:509-606-5040
Mailing Address - Fax:509-946-7253
Practice Address - Street 1:821 SWIFT BLVD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3513
Practice Address - Country:US
Practice Address - Phone:509-606-5040
Practice Address - Fax:509-946-7253
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60150901207L00000X, 207LP2900X, 208VP0000X, 208VP0014X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0448271OtherLABOR AND INDUSTRY
WAP01143104OtherRR MEDICARE
WA1396862868Medicaid
WA0304605OtherLABOR & INDUSTRIES