Individual
MRS. STEPHANIE SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPE, CLS
Contact information
Practice address
103 N TOWER AVE, CENTRALIA, WA 98531-4219
(360) 489-6952
Mailing address
103 N TOWER AVE, CENTRALIA, WA 98531-4219
(360) 489-6952
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BAP-E-10250463
OR
Other
Enumeration date
07/13/2026
Last updated
07/13/2026
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