Shepherd, Dana Marie

Shepherd, Dana Marie is an individual health care provider with primary practice located at 1911 Cooks Hill Rd , Centralia WA 98531-9073. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Shepherd, Dana Marie can be contacted via phone (360) 736-6778.

Contact Information

Primary practice address
1911 Cooks Hill Rd Centralia WA 98531-9073
Phone: (360) 736-6778
Fax: (360) 736-6552
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Pediatrics 163WP0200X RN00145561 Washington
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X AP30006273 Washington

Profile Details

NPI number 1558480749
LBN Legal business name Shepherd, Dana Marie
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2007
Last updated Apr 14th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558480749 NPPES
Washington Other 2914SM REGENCE
Washington MEDICAID 9636994 REGENCE
Washington Other 1194SM REGENCE
Washington MEDICAID 7057375 REGENCE
Washington Other 9116SM REGENCE
Washington MEDICAID 7131717 REGENCE
Washington MEDICAID 7122617 REGENCE
Washington MEDICAID 7131709 REGENCE

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