Individual
BRIAN TODD SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3011 COLUMBIA STREET, VANCOUVER, WA 98660-2237
(360) 693-1291
(360) 693-3392
Mailing address
3011 COLUMBIA STREET, VANCOUVER, WA 98660-2237
(360) 693-1291
(360) 693-3392
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5980
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5095807
—
WA
Enumeration date
12/15/2006
Last updated
07/09/2007
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