Individual
DR. MICHAEL SHAWN MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1502 N VERCLER RD, SPOKANE VALLEY, WA 99216-1078
(509) 444-8200
(509) 434-0392
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8888
(509) 444-7806
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DE61574138
WA
1223G0001X
General Practice Dentistry
00201972
CO
1223G0001X
General Practice Dentistry
DD5553
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500624011
—
OR
05
—
78337372
—
CO
Enumeration date
07/14/2010
Last updated
09/05/2025
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