Individual
SHANTI COLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
406 WELCH ST, SILVERTON, OR 97381-1934
(503) 364-3787
Mailing address
1608 S J ST, FL 1, TACOMA, WA 98405-4930
(253) 274-7501
(253) 274-7991
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201809217
OR
163W00000X
Registered Nurse
RN60939595
WA
367A00000X
Advanced Practice Midwife
202006152NP-PP
OR
367A00000X
Advanced Practice Midwife
Primary
AP61161569
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500781877
—
OR
Enumeration date
09/21/2019
Last updated
02/03/2022
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