Provider Demographics
NPI:1831210749
Name:LAFRANCE, SHELLY L (MN, FNP-BC)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:L
Last Name:LAFRANCE
Suffix:
Gender:F
Credentials:MN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8616 NE 97TH CT
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-4227
Mailing Address - Country:US
Mailing Address - Phone:360-600-4774
Mailing Address - Fax:888-443-5148
Practice Address - Street 1:8616 NE 97TH CT
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-4227
Practice Address - Country:US
Practice Address - Phone:360-600-4774
Practice Address - Fax:888-443-5148
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007234363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9652660Medicaid
WA8866024Medicare PIN