Provider Demographics
NPI:1568850170
Name:DOUGLASS-PARKIN, SHAUNA JOELLE (EAMP, LAC)
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:JOELLE
Last Name:DOUGLASS-PARKIN
Suffix:
Gender:F
Credentials:EAMP, LAC
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:JOELLE
Other - Last Name:DOUGLASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2917 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-3369
Mailing Address - Country:US
Mailing Address - Phone:509-808-0159
Mailing Address - Fax:
Practice Address - Street 1:2917 N MONROE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-3369
Practice Address - Country:US
Practice Address - Phone:509-808-0159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 15952171100000X
WAAC 60525750171100000X
IDACU-305171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist