Individual
SHANA MCQUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
6434 W INTERCHANGE LN, BOISE, ID 83709-2123
(435) 640-5405
Mailing address
6434 W INTERCHANGE LN, BOISE, ID 83709-2123
(435) 640-5405
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
NT60208734
WA
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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