Provider Demographics
NPI:1932554490
Name:DEATON, EMILY SHANNON (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:SHANNON
Last Name:DEATON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:35 W 8TH AVE STE 442
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2361
Mailing Address - Country:US
Mailing Address - Phone:509-456-6556
Mailing Address - Fax:509-413-0812
Practice Address - Street 1:35 W 8TH AVE STE 442
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2361
Practice Address - Country:US
Practice Address - Phone:509-456-6556
Practice Address - Fax:509-413-0812
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA00000002080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program