Individual
SHANNON GLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
415 W 11TH ST, VANCOUVER, WA 98660-3147
(360) 699-2244
Mailing address
415 W 11TH ST, VANCOUVER, WA 98660-3147
(360) 699-2244
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
05/15/2014
Last updated
02/19/2015
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