Provider Demographics
NPI:1487344628
Name:STRASH, SHAWN
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:STRASH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8402 E SUTTON DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-4125
Mailing Address - Country:US
Mailing Address - Phone:602-320-7154
Mailing Address - Fax:
Practice Address - Street 1:8402 E SUTTON DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-4125
Practice Address - Country:US
Practice Address - Phone:602-320-7154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor