| Doctor Name: | DEANA M SHRADER |
| NPI Number: | 1275925661 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MC60514929 |
| License Number: | CO60452219 |
| Business Practice Address: | 1821 Leclerc Rd N #1 Cusick, WA - 991195015 |
| Business Phone Number: | 5094477111 |
| Business Fax Number: | |
| Mailing Address: | 11651 Westside Calispell Rd, USK |
| State: | WA |
| Postal Code: | 991809764 |
| Phone Number: | 5094477402 |
| Fax Number: | |
| NPI Enumeration Date: | 02/23/2015 |
| NPI Last Update Date: | 02/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CO60452219 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |