SHANNON SLACK

OLYMPIA, WA
NPI1790161222
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: WA  AP60571003)
Enumeration Date2015-08-06
Last Update Date2017-04-19
Business Address
-- SHANNON SLACK
2000 LAKERIDGE DR SW
OLYMPIA, WA 98502-6001
Phone number: 360-754-2941
Mailing Address
-- SHANNON SLACK
9039 SILVERSPOT DR SE
TUMWATER, WA 98501-5575
Phone number: 360-791-7133
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