Doctor Name: | MS. COURTNEY JOANNE SHEPHERD |
NPI Number: | 1730419185 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA 60048274 |
Business Practice Address: | 4444 Lacey Blvd Se Ste E Lacey, WA - 985035730 |
Business Phone Number: | 3604381998 |
Business Fax Number: | 3604383524 |
Mailing Address: | 4444 Lacey Blvd Se Ste E, LACEY |
State: | WA |
Postal Code: | 985035730 |
Phone Number: | 3604381998 |
Fax Number: | 3604383524 |
NPI Enumeration Date: | 01/07/2010 |
NPI Last Update Date: | 01/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA 60048274 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |