ETHAN ANDREW SHAFE

REDMOND, OR
NPI1760215123
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-08-21
Last Update Date2024-08-21
Business Address
ETHAN ANDREW SHAFE
852 SW 15TH ST
REDMOND, OR 97756-2507
Phone number: 971-246-4522
Mailing Address
ETHAN ANDREW SHAFE
1380 NE BROOKSTONE LOOP
PRINEVILLE, OR 97754-3233
Phone number: 971-246-4522
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