Individual
SHAWNALYN LORIANN SAN NICOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1780 NE HOSTMARK ST, POULSBO, WA 98370-7682
(360) 396-3165
Mailing address
4071 SUNNYSLOPE RD SW, PORT ORCHARD, WA 98367-7676
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160708634
WA
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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