Individual
CAROL ANN SHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
610 DRAGON DR, MONROE, OR 97456-9604
(541) 847-5143
Mailing address
610 DRAGON DR, MONROE, OR 97456-9604
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PI-0011769
OR
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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