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Individual

SHAWN ANTHONY MIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
909 W MAIN ST STE 102, MONROE, WA 98272-2031
(360) 453-7715
Mailing address
2278 QUINNS MEADOW RD LOT B, COLVILLE, WA 99114-5145
(206) 590-0255

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
WA

Other

Enumeration date
02/06/2023
Last updated
02/06/2023
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