Provider Demographics
NPI:1851678304
Name:WARNICK HENGESH, SHELLEY MAUREED
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:MAUREED
Last Name:WARNICK HENGESH
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 1:1105 N LINCOLN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2138
Mailing Address - Country:US
Mailing Address - Phone:509-252-9891
Mailing Address - Fax:509-838-7503
Practice Address - Street 1:1105 N LINCOLN ST
Practice Address - Street 2:SUITE B
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2138
Practice Address - Country:US
Practice Address - Phone:509-252-9891
Practice Address - Fax:509-838-7503
Is Sole Proprietor?:No
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist