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Individual

SHANA LEE JOHNNY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6501 SR 12, OAKVILLE, WA 98568
(360) 584-8982
Mailing address
PO BOX 384, OAKVILLE, WA 98568-0384
(360) 584-8982

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00113826
WA

Other

Enumeration date
04/02/2020
Last updated
04/02/2020
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