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Individual

SHANNON TERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
840 E HILL AVE, MOSES LAKE, WA 98837-2238
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60631213
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1427416288
WA
01
P01611590
RR PTAN WVH
WA
Enumeration date
02/08/2016
Last updated
09/12/2022
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