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1790283109
SHANE GRIMMETT
LONGVIEW, WA
NPI
1790283109
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: WA CG60830258)
Enumeration Date
2018-01-31
Last Update Date
2018-01-31
Business Address
SHANE GRIMMETT
720 14TH AVE
LONGVIEW, WA 98632-2315
Phone number: 360-423-0203
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Mailing Address
SHANE GRIMMETT
921 14TH AVE
LONGVIEW, WA 98632-2316
Phone number: 360-423-0203
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