Individual
WHITNEY LEIGH SHOFNER MICHALSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(206) 386-2123
(206) 386-6293
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(206) 386-2123
(206) 386-6293
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
60585504
WA
2085R0202X
Diagnostic Radiology Physician
M-14673
ID
2085R0204X
Vascular & Interventional Radiology Physician
Primary
M14673
ID
208600000X
Surgery Physician
MDRE.ML.60375715
WA
Other
Enumeration date
03/19/2013
Last updated
11/25/2020
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