Provider Demographics
NPI:1124828322
Name:PRESTON, SHAWN JAMES SR
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:JAMES
Last Name:PRESTON
Suffix:SR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-3609
Mailing Address - Country:US
Mailing Address - Phone:509-570-7250
Mailing Address - Fax:509-982-8989
Practice Address - Street 1:105 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3609
Practice Address - Country:US
Practice Address - Phone:509-570-7250
Practice Address - Fax:509-982-8989
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist