Provider Demographics
NPI:1700842523
Name:FERCH, SHANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHANN
Middle Name:
Last Name:FERCH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 E BOONE
Mailing Address - Street 2:AD BOX 25
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99258-0001
Mailing Address - Country:US
Mailing Address - Phone:509-328-4220
Mailing Address - Fax:509-228-9542
Practice Address - Street 1:714 E BOONE
Practice Address - Street 2:AD BOX 25
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99258-0001
Practice Address - Country:US
Practice Address - Phone:509-328-4220
Practice Address - Fax:509-228-9542
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002058103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical