Individual
CAROL L SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
Mailing address
38414 SE 10TH ST, WASHOUGAL, WA 98671-7780
(360) 409-3942
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA212621
OR
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/02/2021
Last updated
01/23/2023
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