Provider Demographics
NPI:1396786125
Name:SHOOK, DARIN J (DO)
Entity type:Individual
Prefix:DR
First Name:DARIN
Middle Name:J
Last Name:SHOOK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1312 VANDERCOOK WAY
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3902
Mailing Address - Country:US
Mailing Address - Phone:360-425-6620
Mailing Address - Fax:360-425-1277
Practice Address - Street 1:1312 VANDERCOOK WAY
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3902
Practice Address - Country:US
Practice Address - Phone:360-425-6620
Practice Address - Fax:360-425-1277
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033964111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB25385Medicare ID - Type Unspecified