Individual
SHANNON KAY WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFA, CST
Contact information
Practice address
3155 CHANNING WAY, SUITE B, IDAHO FALLS, ID 83404-7561
(208) 535-4800
Mailing address
1200 BARNEY DAIRY RD, REXBURG, ID 83440-3546
(208) 709-2063
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102652
CST, CFA
ID
Enumeration date
01/17/2007
Last updated
07/16/2009
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