Individual
JESSE R SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 501-3500
(360) 501-3555
Mailing address
PO BOX 3002, LONGVIEW, WA 98632-0302
(360) 501-3500
(360) 501-3555
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA60108805
WA
Other
Enumeration date
10/27/2009
Last updated
10/27/2009
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