Individual
DR. ZACCHARY SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9040A JACKSON AVE, JOINT BASE LEWIS MCCHORD, WA 98431-5001
(253) 968-1110
Mailing address
14675 SKOG RD, GRANTSBURG, WI 54840-8381
(763) 447-9512
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
43-558007-012
KS
Other
Enumeration date
06/30/2022
Last updated
12/20/2023
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