Individual
SHANE LEE COUGHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2301 COVE AVE, LA GRANDE, OR 97850-3906
(541) 962-8811
Mailing address
2301 COVE AVE, LA GRANDE, OR 97850-3906
(541) 962-8811
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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