Individual
SHELLY LYNN LARGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 SE WASHINGTON AVE., OPTIONAL, CHEHALIS, WA 98532
(360) 507-8032
Mailing address
500 SE WASHINGTON AVE., OPTIONAL, CHEHALIS, WA 98532
(360) 507-8032
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60298456
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2077844
—
WA
Enumeration date
07/01/2021
Last updated
07/01/2021
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