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1013478759
SHANE RANDAL DAVIS
PULLMAN, WA
NPI
1013478759
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
372600000X Adult Companion
Enumeration Date
2019-03-26
Last Update Date
2022-08-24
Business Address
SHANE RANDAL DAVIS
340 NE MAPLE ST
PULLMAN, WA 99163-4120
Phone number: 509-334-1133
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Mailing Address
SHANE RANDAL DAVIS
340 NE MAPLE ST
PULLMAN, WA 99163-4120
Phone number: 509-334-1133
Copy
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