Male or Other

Shane R. Davis

Counselor in Pullman, WA(View on Map)

Full Name

Shane Randal Davis

NPI Number

1013478759

NPI Type

Individual Provider

Gender

Male

Enumeration Date

03/26/2019

Specialties

(Taxonomies)

Code

101Y00000X
372600000X

Primary Taxonomy

Yes
No

Contact
Information

Purpose

Mailing
Location

Address

340 NE MAPLE ST
340 NE MAPLE ST

City

Pullman
Pullman

State

WA
WA

Postal Code

99163-4120
99163-4120

Country

US
US

Telephone Number

(509) 334-1133
(509) 334-1133

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/24/2022

Provider Address

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