Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN00000334 | WA |
NPI | 1912124223 |
---|---|
Provider Name | Rhonda Renee Sheeler |
First Address | Kelso, WA 98626-3413 |
Second Address | Kelso, WA 98626-3413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |