Individual
MISS MOLLY MAUREEN SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
240 NORTH A STREET, BUCKLEY, WA 98321
(360) 829-5831
Mailing address
1906 WILSON AVE, ENUMCLAW, WA 98022-3302
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
61407219
WA
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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