Individual
MISS RESA SHANER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1701 N 13TH ST STE 100, SHELTON, WA 98584-2077
(360) 426-2653
(360) 427-7086
Mailing address
PO BOX 1668, SHELTON, WA 98584-5001
(360) 427-9549
(360) 427-7086
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004256
WA
Other
Enumeration date
09/30/2005
Last updated
11/17/2020
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