Individual
SHAWN DEMETRIUS SIMMONS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
118 E 8TH ST, PORT ANGELES, WA 98362
(360) 457-0431
(360) 457-0493
Mailing address
118 E 8TH ST, PORT ANGELES, WA 98362-6129
(360) 457-0431
(360) 457-0493
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/14/2016
Last updated
05/20/2021
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