Individual
SHANNON E MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
50001694
OH
363AM0700X
Medical Physician Assistant
Primary
PA60646227
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538367362
—
WA
01
—
P01661883
RR PTAN WVC
WA
Enumeration date
07/03/2007
Last updated
07/05/2024
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