Provider Demographics
NPI:1427870260
Name:MORK, SHAWN TOOLE (RN)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:TOOLE
Last Name:MORK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10107 E 8TH AVE APT 31
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6928
Mailing Address - Country:US
Mailing Address - Phone:717-615-8070
Mailing Address - Fax:
Practice Address - Street 1:497 S BECK RD
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-4891
Practice Address - Country:US
Practice Address - Phone:208-618-6911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60517502163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency