Individual
SHANNON L PAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 205-8003
Mailing address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 205-8003
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN61215185
WA
Other
Enumeration date
12/30/2022
Last updated
12/30/2022
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