Provider Demographics
NPI:1710955307
Name:SHUSTER, JOHN K (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:K
Last Name:SHUSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W 5TH AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2715
Mailing Address - Country:US
Mailing Address - Phone:509-344-2663
Mailing Address - Fax:509-624-9179
Practice Address - Street 1:601 W 5TH AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2715
Practice Address - Country:US
Practice Address - Phone:509-344-2663
Practice Address - Fax:509-624-9179
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00036590207XS0117X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0034606Medicaid
WA379109600OtherOWCP
ID805241500Medicaid
WA8229817Medicaid
WA123388OtherDEPT OF LABOR & INDUSTRIE
WA89220026OtherCRIME VICTIMS
IDKB780OtherBLUE CROSS OF ID
WASH7670OtherASURIS NW HEALTH
ID000010004895OtherBLUE SHIELD OF IDAHO
WA14477OtherGROUP HEALTH NW
ID000010004892OtherREGENCE BLUE SHIELD OF ID
WA200031946OtherRR MEDICARE
IDKB780OtherBLUE CROSS OF ID
WA8229817Medicaid
WA89220026OtherCRIME VICTIMS