Individual
JAMES RAYMOND SHOGREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDPT
Contact information
Practice address
1956 NE KRESKY AVENUE, CHEHALIS, WA 98532-2307
(360) 740-4380
(360) 740-1877
Mailing address
PO BOX 59, CHEHALIS, WA 98532
(360) 740-4380
(360) 740-1877
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
61172073
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2178704
—
WA
Enumeration date
05/24/2019
Last updated
08/12/2022
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