Individual
DANIEL SPENCER RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 205-8001
Mailing address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 205-8001
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00050976
WA
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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