Individual
DR. RICHARD W. SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., P.S.
Contact information
Practice address
617 CEMETARY RD, WINLOCK, WA 98596-9303
(360) 785-4755
(360) 785-3336
Mailing address
617 CEMETARY RD, WINLOCK, WA 98596-9303
(360) 785-4755
(360) 785-3336
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00004304
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29532
L & I
WA
05
—
539-3608
—
WA
Enumeration date
07/11/2007
Last updated
07/11/2007
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