Shane Randal Davis
NPI #1013478759 in Pullman, Washington
Provider Information
- NPI Number
- 1013478759
- Entity Type
- Individual
- Name
- Shane Randal Davis
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor
- Enumeration Date
- Mar 26, 2019
- Last Updated
- Aug 24, 2022
Practice Location
- Address
- 340 NE MAPLE ST
- City
- Pullman
- State
- Washington
- ZIP Code
- 99163-4120
- Phone
- (509) 334-1133
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
| Adult Companion |
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