Steven Lee Shahan Jr., CG61060674
Counselor in Centralia, WA. Individual provider (NPI-1).
NPI number1164051736
StatusActive
Last updated in NPPESApr 6, 2020
Details
- NPI
- 1164051736
- Entity type
- Individual (NPI-1)
- Name
- Mr. Steven Lee Shahan Jr.
- Credential
- CG61060674
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 6, 2020
- Certification date
- Apr 6, 2020
- Last updated
- Apr 6, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | CG61060674 | WA | Yes |
Practice location
2428 W Reynolds AveCentralia, WA 98531-4554
Phone 360-623-8020
Mailing address
6818 Desperado Dr SeTumwater, WA 98501-6106
Phone 360-522-1574
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