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NPI Code Detail

MEDICARE: MS. SHAILA MAE ALTER LMT

MEDICARE:  MS. SHAILA MAE ALTER  LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMA00021952WA

General Provider Information

NPI Number : 1356419907
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHAILA MAE ALTER LMT
Provider Business Mailing Address
First Line : PO BOX 513
Second Line :
City : SANDY
State : OR
Zip : 97055-0513
Country : US
Telephone Number : 503-319-5349
Fax Number : 503-668-7084
Provider Business Practice Location Address
First Line : 11516 SE MILL PLAIN BLVD
Second Line : SUITE 2B
City : VANCOUVER
State : WA
Zip : 98684-5005
Country : US
Telephone Number : 360-253-6674
Fax Number : 360-253-8670
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 07/08/2007

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Directions to “ MS. SHAILA MAE ALTER LMT” Practice Location

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