Individual
SHAYNE IMMEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
721 FAWCETT AVE STE 100, TACOMA, WA 98402-5502
(253) 250-1243
Mailing address
721 FAWCETT AVE STE 101, TACOMA, WA 98402-5502
(253) 250-1243
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/12/2020
Last updated
05/12/2020
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