Individual
TINA FENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4240 E PICKERING RD, SHELTON, WA 98584-8888
(360) 509-6492
Mailing address
4240 E PICKERING RD, SHELTON, WA 98584-8888
(360) 509-6492
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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