IndividualActive
Michael Shaffer, COTA
NPI 1740654318 · Student in an Organized Health Care Education/Training Program · Ruston, WA
Provider details
- NPI number
- 1740654318
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- COTA
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Student, Health Care
Practice location
5109 N 49th St
Ruston, WA 98407-3024
Phone: (360) 412-4400
Approximate (ZIP-level) locationGet directions
Mailing address
5109 N 49th St
Ruston, WA 98407-3024
Registry dates
- Enumerated
- 2015-11-19
- Last updated
- 2015-11-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.