Provider Demographics
NPI:1497029235
Name:SHAH, NASREEN S
Entity Type:Individual
Prefix:
First Name:NASREEN
Middle Name:S
Last Name:SHAH
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 1:1924 S ROCKY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-3259
Mailing Address - Country:US
Mailing Address - Phone:509-868-7388
Mailing Address - Fax:
Practice Address - Street 1:2323 N DISCOVERY PL
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1566
Practice Address - Country:US
Practice Address - Phone:509-747-4174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health