Ethan Andrew Shafe
Ethan Andrew Shafe is a Student in an Organized Health Care Education/Training Program in Redmond, Oregon. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
852 SW 15th StRedmond, OR 97756-2507
Phone: (971) 246-4522
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1760215123 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | August 21, 2024 |
| Last updated in NPPES | August 21, 2024 |
| Certification date | August 21, 2024 |
| Mailing address | 1380 Ne Brookstone Loop, Prineville, OR 97754-3233 |
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