Individual
SHAWNN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA 60593496
Contact information
Practice address
1611 E 13TH AVE, SPOKANE, WA 99202-3539
(208) 255-9842
Mailing address
1611 E 13TH AVE, SPOKANE, WA 99202-3539
(208) 255-9842
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60593496
WA
Other
Enumeration date
05/25/2016
Last updated
05/25/2016
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