Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT0010538 | WA |
NPI | 1013104082 |
---|---|
Provider Name | Wendy Shaw |
First Address | Spokane, WA 99217-9667 |
Second Address | Spokane Valley, WA 99206-4239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2007 |
Last Update Date | 01/11/2007 |