Individual
MRS. SHIRLEY M PRYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
176 1ST AVE N, PO DRAWER N, ILWACO, WA 98624
(360) 642-3747
(360) 642-3361
Mailing address
176 1ST AVE N, PO DRAWER N, ILWACO, WA 98624
(360) 642-3747
(360) 642-3361
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30003770
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9616582
—
WA
01
—
PR8034
BCBS
WA
Enumeration date
10/03/2005
Last updated
06/27/2013
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