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1619187788
SHAWNLY ELISE WALLACE
TACOMA, WA
NPI
1619187788
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WA PT00005001)
Enumeration Date
2007-05-23
Last Update Date
2007-07-08
Business Address
-- SHAWNLY ELISE WALLACE PT
4020 S 56TH ST STE 101
TACOMA, WA 98409-2626
Phone number: 253-475-6862
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Mailing Address
-- SHAWNLY ELISE WALLACE PT
25813 68TH AVE E
GRAHAM, WA 98338-7133
Phone number: 253-820-8816
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