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Individual

SHANNON SUE GOLDSBERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.P.

Contact information

Practice address
7010 27TH ST W, UNIVERSITY PLACE, WA 98466-5215
(253) 534-8102
(253) 565-3346
Mailing address
7010 27TH ST W, UNIVERSITY PLACE, WA 98466-5215
(253) 534-8102
(253) 565-3346

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA00010503
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0182749
WASHINGTON STATE DEPARTMENT OF LABOR AND INDUSTRIES
WA
Enumeration date
06/26/2008
Last updated
06/26/2008
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