Individual
MR. WAYNE H SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12607 SE MILL PLAIN BLVD, CASCADE PARK MEDICAL OFFICE, VANCOUVER, WA 98684-6055
(360) 418-6001
Mailing address
23414 NE 139TH LOOP, BRUSH PRAIRIE, WA 98606-9624
(360) 896-5153
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO00001507
WA
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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