Provider Demographics
NPI:1780901512
Name:SCHRUNK, SASHA JEAN (DO, PHD)
Entity type:Individual
Prefix:DR
First Name:SASHA
Middle Name:JEAN
Last Name:SCHRUNK
Suffix:
Gender:F
Credentials:DO, PHD
Other - Prefix:DR
Other - First Name:SASHA
Other - Middle Name:JEAN
Other - Last Name:FACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54702-1510
Mailing Address - Country:US
Mailing Address - Phone:608-785-0940
Mailing Address - Fax:
Practice Address - Street 1:191 THEATER RD
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-8679
Practice Address - Country:US
Practice Address - Phone:608-392-5003
Practice Address - Fax:608-392-5789
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI62286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program