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1871699017
WAYNE H SHEPARD
VANCOUVER, WA
NPI
1871699017
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
156FX1800X Technician/Technologist, Optician
(Licence: WA DO00001507)
Enumeration Date
2006-09-15
Last Update Date
2007-07-08
Business Address
Mr. WAYNE H SHEPARD
12607 SE MILL PLAIN BLVD CASCADE PARK MEDICAL OFFICE
VANCOUVER, WA 98684-6055
Phone number: 360-418-6001
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Mailing Address
Mr. WAYNE H SHEPARD
23414 NE 139TH LOOP
BRUSH PRAIRIE, WA 98606-9624
Phone number: 360-896-5153
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