Provider Demographics
NPI:1427786417
Name:SHAUGHNESSEY, VANESSA YVETTE (DNP)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:YVETTE
Last Name:SHAUGHNESSEY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:YVETTE
Other - Last Name:DE LA TORRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:PO BOX 5299
Mailing Address - Street 2:MS: 820-5-PCO
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1415 N HOUK RD STE A
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1043
Practice Address - Country:US
Practice Address - Phone:509-924-1990
Practice Address - Fax:509-232-3059
Is Sole Proprietor?:No
Enumeration Date:2022-08-09
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61342595363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner