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Individual

SHI YAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DENTURIST

Contact information

Practice address
3100 SE OLD OLYMPIC HWY, SHELTON, WA 98584-7731
(360) 427-1784
(360) 427-1818
Mailing address
3100 SE OLD OLYMPIC HWY, SHELTON, WA 98584-7731
(360) 427-1784
(360) 427-1818

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000236
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5035415
WA
Enumeration date
04/19/2007
Last updated
07/09/2007
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