SHELBY LIDSTROM

MONROE, WA
NPI1154722155
Former NameSHELBY A MYERS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: WA  PA60463924)
Enumeration Date2014-09-09
Last Update Date2014-09-09
Business Address
-- SHELBY LIDSTROM
19200 N KELSEY ST
MONROE, WA 98272-1431
Phone number: 360-794-7994
Mailing Address
-- SHELBY LIDSTROM
PO BOX 3360
PORTLAND, OR 97208-3360
Phone number: 866-366-2983
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