Individual
CRYSTAL ROSE SHUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
400 E 33RD ST, VANCOUVER, WA 98663-2238
(360) 696-2561
Mailing address
511 W EVERGREEN BLVD #107, VANCOUVER, WA 98660-3002
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
08925
OR
225200000X
Physical Therapy Assistant
Primary
P160321635
WA
Other
Enumeration date
01/03/2014
Last updated
01/03/2014
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