Doctor Name: | SHELLY SKILES |
NPI Number: | 1114358843 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 00008818 |
Business Practice Address: | 211 Ne Skyline Dr White Salmon, WA - 986721948 |
Business Phone Number: | 5094935119 |
Business Fax Number: | |
Mailing Address: | 211 Ne Skyline Dr, WHITE SALMON |
State: | WA |
Postal Code: | 986721948 |
Phone Number: | 5094935119 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2013 |
NPI Last Update Date: | 12/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 00008818 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |