Individual
JILL SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
950 BROADWAY STE 301, TACOMA, WA 98402-4454
(253) 292-4354
Mailing address
10658 OLALLA VALLEY RD SE, OLALLA, WA 98359-9738
(801) 520-6010
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/17/2025
Last updated
05/17/2025
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