Fettig, Shawn Mikeal
Fettig, Shawn Mikeal is an individual health care provider with primary practice located at 2701 Ne 114 Ave #K6, Vancouver WA 98684-4289. He recently has only one registered license in Dental Providers / Denturist, which is considered as his primary health care specialty. Fettig, Shawn Mikeal can be contacted via phone (360) 892-7107.Contact Information
Primary practice address
2701 Ne 114 Ave #K6
Vancouver WA 98684-4289
Phone: (360) 892-7107
Fax: (360) 891-8361
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Denturist | 122400000X | ON00000393 | Washington |
Profile Details
| NPI number | 1942398524 |
|---|---|
| LBN Legal business name | Fettig, Shawn Mikeal |
| Credentials | LD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942398524 | NPPES |
| Washington | MEDICAID | 5047576 |
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