Individual
SHANE B MERRILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
625 9TH AVE, LONGVIEW, WA 98632-2464
(360) 442-7900
Mailing address
625 9TH AVE, LONGVIEW, WA 98632-2464
(360) 501-3449
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60510081
WA
367500000X
Certified Registered Nurse Anesthetist
SRA100020
CO
Other
Enumeration date
01/20/2011
Last updated
06/25/2024
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