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Individual

CAROLINE KELLER SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
16819 NE 159TH ST, BRUSH PRAIRIE, WA 98606-7323
(360) 448-6450
Mailing address
230 W WINDSOR AVE, ALEXANDRIA, VA 22301-1518
(703) 819-6915

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
06/28/2018
Last updated
06/28/2018
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