Provider Demographics
NPI:1831298611
Name:SHRINER, DEAN LYLE (ARNP)
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:LYLE
Last Name:SHRINER
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:VAUGHN
Mailing Address - State:WA
Mailing Address - Zip Code:98394-0129
Mailing Address - Country:US
Mailing Address - Phone:253-884-9221
Mailing Address - Fax:253-884-5523
Practice Address - Street 1:15610 89TH STREET COURT KP N
Practice Address - Street 2:
Practice Address - City:LAKEBAY
Practice Address - State:WA
Practice Address - Zip Code:98349-9551
Practice Address - Country:US
Practice Address - Phone:253-884-9221
Practice Address - Fax:253-884-5523
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30000014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily