Individual
SHANE A HAGGERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
44 E COZZA DR, SPOKANE, WA 99208-6514
(509) 325-6800
Mailing address
44 E COZZA DR, SPOKANE, WA 99208-6514
(509) 325-6800
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60027137
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2077844
—
WA
Enumeration date
04/02/2020
Last updated
04/02/2020
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