Shelby Lidstrom

NPI #1154722155 in Monroe, Washington

Provider Information

NPI Number: 1154722155
Entity Type: Individual
Name: Shelby Lidstrom
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Sep 9, 2014
Last Updated: Jul 24, 2025

Practice Location

Address: 19200 N KELSEY ST
City: Monroe
State: Washington
ZIP Code: 98272-1431
Phone: (360) 794-7994

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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