Shelby, Diana Sue

Shelby, Diana Sue is an individual health care provider with primary practice located at 5219 West Clearwater Ave Suite 8, Kennewick WA 99336. She recently has only one registered license in Dental Providers / Denturist, which is considered as her primary health care specialty. Shelby, Diana Sue can be contacted via phone (509) 374-1660.

Contact Information

Primary practice address
5219 West Clearwater Ave Suite 8 Kennewick WA 99336
Phone: (509) 374-1660
Fax: (509) 374-9374
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Denturist 122400000X DN00000253 Washington

Profile Details

NPI number 1104933571
LBN Legal business name Shelby, Diana Sue
Credentials DPD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Jul 8th, 2007 - about 17 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 1104933571 NPPES
Washington MEDICAID 15049275

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