Individual
KYLE SHANKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1601 AVENUE D, SNOHOMISH, WA 98290-1718
(360) 563-7300
Mailing address
214 161ST ST SE, BOTHELL, WA 98012-6332
(425) 737-3944
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60896013
WA
Other
Enumeration date
10/18/2018
Last updated
10/18/2018
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