Individual
SHAUNA LEIGH MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2609 SUNNYBROOK DR, NAMPA, ID 83686-6332
(208) 467-7298
Mailing address
1736 N ELDORADO ST, BOISE, ID 83704-7403
(714) 269-1009
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TSLP-3994
ID
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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