Provider Demographics
NPI:1730233503
Name:SHIRLEY, STEVEN L (DC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:L
Last Name:SHIRLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12905 E SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-0731
Mailing Address - Country:US
Mailing Address - Phone:509-922-0303
Mailing Address - Fax:509-922-0657
Practice Address - Street 1:12905 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0731
Practice Address - Country:US
Practice Address - Phone:509-922-0303
Practice Address - Fax:509-922-0657
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002606111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA44392OtherLABOR & INDUSTRIES
WA612948OtherACN PROVIDER ID
WA000010020750OtherREGENCE BLS OF ID ID #
WAE02528OtherASURIS PROVIDER ID
WA13870OtherAWHN PROVIDER ID
WA000010020750OtherREGENCE BLS OF ID ID #
WA612948OtherACN PROVIDER ID