Individual
JACKIE SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 205-8010
Mailing address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 205-8010
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60198375
WA
Other
Enumeration date
03/02/2023
Last updated
03/02/2023
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