Individual
DR. SHANE D. BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
7307 40TH ST W STE B, UNIVERSITY PLACE, WA 98466-4385
(253) 753-6204
Mailing address
4250 ALTURUS ST W, UNIVERSITY PLACE, WA 98466-6612
(281) 881-4683
(281) 842-7701
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
11178
TX
111N00000X
Chiropractor
713689
OR
111N00000X
Chiropractor
CH00034742
WA
Other
Enumeration date
10/13/2006
Last updated
01/14/2023
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