Provider Demographics
NPI:1487620266
Name:HORN, SHAWN (PSYD, PS)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:
Last Name:HORN
Suffix:
Gender:F
Credentials:PSYD, PS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S FREYA ST
Mailing Address - Street 2:STE 215B ORANGE FLAG BLDG
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-4862
Mailing Address - Country:US
Mailing Address - Phone:509-535-2045
Mailing Address - Fax:509-535-2046
Practice Address - Street 1:104 S FREYA ST
Practice Address - Street 2:STE 215B ORANGE FLAG BLDG
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-4862
Practice Address - Country:US
Practice Address - Phone:509-535-2045
Practice Address - Fax:509-535-2046
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60104618103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical