Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO00000648 | WA |
Y | 222Z00000X | Podiatrist | PO00000648 | WA |
NPI | 1003809252 |
---|---|
Provider Name | Shani Mcginnis |
First Address | Spokane, WA 99220-3649 |
Second Address | Spokane Valley, WA 99216-2167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 12/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8250250 | (05) | WA |
U76638 | (02) |