Shannon C Fuller, LMP

NPI #1194853036 in Bellingham, Washington

Provider Information

NPI Number: 1194853036
Entity Type: Individual
Name: Shannon C Fuller, LMP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: LMP
Enumeration Date: Mar 1, 2007
Last Updated: Jun 16, 2014

Practice Location

Address: 120 PROSPECT ST STE 1
City: Bellingham
State: Washington
ZIP Code: 98225-4428
Phone: (360) 303-8961

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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