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Individual

PETER K SHAFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS CCC-SLP

Contact information

Practice address
25 TERRACE DR, VANCOUVER, WA 98661-5774
(360) 694-6064
Mailing address
11405 NE 69TH ST, VANCOUVER, WA 98662-4817
(360) 604-6975

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
439179C
WA

Other

Enumeration date
12/14/2012
Last updated
06/10/2013
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