| NPI | 1194840520 |
|---|---|
| Other Name | S CRAIG SHIVELY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10003914) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10003914) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2025-05-12 |