Individual
JAKE SHANEYFELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 N CENTRAL AVE, PHOENIX, AZ 85012-2637
(602) 812-4312
Mailing address
4575 E CHISUM TRL, PHOENIX, AZ 85050-8527
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
AZ
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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