Provider Demographics
NPI:1467411967
Name:TROY, SHAUNA
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:TROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 E 5TH
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1313
Mailing Address - Country:US
Mailing Address - Phone:509-624-1308
Mailing Address - Fax:509-624-5537
Practice Address - Street 1:502 E 5TH
Practice Address - Street 2:THOMPSON CUSTOM ORTHOTIC & PROSTHETIC
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1313
Practice Address - Country:US
Practice Address - Phone:509-624-1308
Practice Address - Fax:509-624-5537
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter