Provider Demographics
NPI:1477190304
Name:SCHUEREN, SHANNON RACHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:RACHAEL
Last Name:SCHUEREN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:RACHAEL
Other - Last Name:ROMEIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 700688
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78270-0688
Mailing Address - Country:US
Mailing Address - Phone:866-838-3330
Mailing Address - Fax:210-468-0682
Practice Address - Street 1:15021 MAIN ST STE K
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1651
Practice Address - Country:US
Practice Address - Phone:800-404-6050
Practice Address - Fax:866-313-3397
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60989179111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACH60989179OtherWASHINGTON STATE DEPARTMENT OF HEALTH