Individual
SHANALEE RADACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2929 5TH AVE NE, PUYALLUP, WA 98372-6782
(253) 447-8216
(253) 447-8789
Mailing address
12703 117TH AVE E, PUYALLUP, WA 98374-4070
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC 60186883
WA
Other
Enumeration date
01/26/2011
Last updated
04/24/2012
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