Individual
MARISA SHANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1312 WOODBURY ST, RICHLAND, WA 99354-2866
(909) 524-5613
Mailing address
1312 WOODBURY ST, RICHLAND, WA 99354-2866
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
WALP60667814
WA
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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