IndividualActive
Jesse Shaw, D.O
NPI 1912293572 · Sports Medicine (Family Medicine) Physician · Pullman, WA
Provider details
- NPI number
- 1912293572
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O
- Sex
- Male
- Sole proprietor
- Yes
- License
- O-1908 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
825 Se Bishop Blvd Ste 120
Pullman, WA 99163-5517
Phone: (509) 332-2828
Approximate (ZIP-level) locationGet directions
Mailing address
825 Se Bishop Blvd Ste 120
Pullman, WA 99163-5517
Additional practice locations (1)
- 2500 W a St Ste 201Moscow, ID 83843-6000Phone: (208) 883-2828Fax: (208) 882-2179
Registry dates
- Enumerated
- 2011-06-22
- Last updated
- 2025-09-29
- Certified
- 2025-09-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.