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Organization
SHELTON FAMILY MEDICINE PLLC
Active
Organization
SHELTON FAMILY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA LEE LANMAN (ASSISTANT OFFICE MANAGER)
(360) 426-2653
Entity
Organization
Contact information
Practice address
939 MOUNTAIN VIEW DRIVE, STE 100, SHELTON, WA 98584-4410
(360) 426-2653
(360) 427-7086
Mailing address
939 MOUNTAIN VIEW DRIVE, STE 100, SHELTON, WA 98584-4410
(360) 426-2653
(360) 427-7086
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
601868919
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G000247600
MEDICARE ASSIGNED CLINIC NUMBER
WA
Enumeration date
04/17/2007
Last updated
10/16/2008
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