Individual
MR. SHANE M. TSUBAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1500 109TH AVE NE, BLAINE, MN 55449-4670
(866) 389-2727
Mailing address
15744 FAIROAKS AVE N, HUGO, MN 55038-8552
(541) 212-9382
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/12/2008
Last updated
12/10/2025
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