Individual
SHASTA LEE CARLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8202 N DIVISION ST, SPOKANE, WA 99208-5713
(509) 603-3335
Mailing address
612 E BALLARD RD, COLBERT, WA 99005-8516
(509) 603-3335
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN60993350
WA
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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