Provider Demographics
NPI:1922507813
Name:DURGAN, SHERYL DEAN
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:DEAN
Last Name:DURGAN
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:PO BOX 4627
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-0627
Mailing Address - Country:US
Mailing Address - Phone:509-624-1244
Mailing Address - Fax:509-624-6240
Practice Address - Street 1:2308 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-5810
Practice Address - Country:US
Practice Address - Phone:509-624-1244
Practice Address - Fax:509-624-6240
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2014039828163WP0808X
WACP00001151101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)