Provider Demographics
NPI:1396886990
Name:SHOEMAKER, JEFFREY LEON (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LEON
Last Name:SHOEMAKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6417
Mailing Address - Country:US
Mailing Address - Phone:509-328-6812
Mailing Address - Fax:509-329-0579
Practice Address - Street 1:501 W FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6417
Practice Address - Country:US
Practice Address - Phone:509-328-6812
Practice Address - Fax:509-329-0579
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003633111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAUZ3744Medicare UPIN
WAAB07325Medicare ID - Type Unspecified