Individual
ROBERT L SHELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
551 S E MAYLOR ST, OAK HARBOR, WA 98277-5000
(360) 675-4954
(360) 675-4968
Mailing address
551 S E MAYLOR ST, OAK HARBOR, WA 98277-5000
(360) 675-4954
(360) 675-4968
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0252 02 00002035
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0252-02 00002035
WA STATE LICENSE #
WA
05
—
8348112
—
WA
01
—
91-1619092
FED ID #
WA
Enumeration date
11/17/2006
Last updated
07/29/2008
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