Organization
SHANNON REITAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON REITAN (SELF)
(817) 637-4425
Entity
Organization
Contact information
Practice address
520 SPRING ST, FRIDAY HARBOR, WA 98250-8057
(817) 637-4425
Mailing address
520 SPRING ST, FRIDAY HARBOR, WA 98250-8057
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
CO 60629779
WA
Other
Enumeration date
05/07/2016
Last updated
05/07/2016
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