Provider Demographics
NPI:1942924345
Name:SIEGEL, SHARON VESTA
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:VESTA
Last Name:SIEGEL
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 1:3209 S DEARBORN LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-1535
Mailing Address - Country:US
Mailing Address - Phone:208-600-7402
Mailing Address - Fax:
Practice Address - Street 1:3209 S DEARBORN LN
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-1535
Practice Address - Country:US
Practice Address - Phone:208-600-7402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide