Provider Demographics
NPI:1700176252
Name:HOFFROGGE, SHAWN P (DOC)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:P
Last Name:HOFFROGGE
Suffix:
Gender:M
Credentials:DOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-4940
Mailing Address - Country:US
Mailing Address - Phone:253-756-7500
Mailing Address - Fax:253-756-7501
Practice Address - Street 1:3901 6TH AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-4940
Practice Address - Country:US
Practice Address - Phone:253-756-7500
Practice Address - Fax:253-756-7501
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-17
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5543111N00000X
WACH61475607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor