Individual
SHANNON C FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
120 PROSPECT ST STE 1, BELLINGHAM, WA 98225-4428
(360) 303-8961
(360) 734-4148
Mailing address
120 PROSPECT ST STE 1, BELLINGHAM, WA 98225-4428
(360) 303-8961
(360) 734-4148
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00017407
WA
Other
Enumeration date
03/01/2007
Last updated
06/16/2014
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