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Organization

MOONSTONE MEDICAL GROUP, PLLC

Active
Other names
Shelly LaFrance, FNP, PLLC
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHELLY LAFRANCE MN, FNP-BC (NURSE PRACTITIONER)
(360) 326-3171
Entity
Organization

Contact information

Practice address
9320 NE VANCOUVER MALL DR, SUITE 103, VANCOUVER, WA 98662-8203
(360) 326-3171
(360) 326-3355
Mailing address
9320 NE VANCOUVER MALL DR, SUITE 103, VANCOUVER, WA 98662-8203
(360) 326-3171

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30007234
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9652660
WA
Enumeration date
09/28/2015
Last updated
12/17/2015
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