Kyle Shafer
NPI #1376172775 in Ilwaco, Washington
Provider Information
- NPI Number
- 1376172775
- Entity Type
- Individual
- Name
- Kyle Shafer
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Enumeration Date
- Apr 7, 2020
- Last Updated
- Jul 22, 2020
Practice Location
- Address
- 176 1ST AVE N
- City
- Ilwaco
- State
- Washington
- ZIP Code
- 98624-9137
- Phone
- (360) 642-3747
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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