Individual
SHANNON KAY BOUGIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9505 S STEELE ST, TACOMA, WA 98444-1858
(253) 597-6825
Mailing address
1823 5TH ST SW, PUYALLUP, WA 98371-7443
(253) 597-6825
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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