SHANNON DWAYNE KRETZ

KELSO, WA
NPI1861977936
Other NameSHANNON DWAYNE BENJAMIN
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
(Licence: WA  60871961)
Enumeration Date2018-09-25
Last Update Date2019-02-05
Business Address
SHANNON DWAYNE KRETZ AA, CDPT
309 OAK ST
KELSO, WA 98626-2340
Phone number: 360-423-0203
Mailing Address
SHANNON DWAYNE KRETZ AA, CDPT
921 14TH AVENUE
LONGVIEW, WA 98632
Phone number: 360-423-0203
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