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Individual

DIANA SUE SHELBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPD

Contact information

Practice address
5219 WEST CLEARWATER AVE, SUITE 8, KENNEWICK, WA 99336
(509) 374-1660
(509) 374-9374
Mailing address
5219 WEST CLEARWATER AVE, SUITE 8, KENNEWICK, WA 99336
(509) 374-1660
(509) 374-9374

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000253
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
15049275
WA
Enumeration date
08/23/2006
Last updated
07/08/2007
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