Individual
MRS. DEEANNE RENEE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
7719 SWANSON DR NW, GIG HARBOR, WA 98335-6439
(253) 377-4417
Mailing address
7719 SWANSON DR NW, GIG HARBOR, WA 98335-6439
(253) 377-4417
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA00025200
WA
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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