Individual
SHANE TODD MILWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2204 PACIFIC AVE N, LONG BEACH, WA 98631-3300
(360) 642-3787
(360) 642-2096
Mailing address
2204 PACIFIC AVE N, LONG BEACH, WA 98631-3300
(360) 642-3787
(360) 642-2096
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/01/2019
Last updated
07/01/2019
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