Individual
SHANNON P LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
500 SE WASHINGTON AVE, CHEHALIS, WA 98532-3058
(360) 748-4776
Mailing address
500 SE WASHINGTON AVE, CHEHALIS, WA 98532-3058
(360) 748-4776
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61367990
WA
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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