# SHANNON T. THOM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1316175037
- **Gender:** F
- **Credential:** ARNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 200941252RN | OR | — |
| 363L00000X | Nurse Practitioner | AP60081915 | WA | Yes |
| 363LF0000X | Family Nurse Practitioner | 200950065NP | OR | — |
| 363LF0000X | Family Nurse Practitioner | AP60081915 | WA | — |

## Other

- **Enumeration date:** 07/01/2009
- **Last updated:** 07/24/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1619915113 | CLINIC GROUP NPI | — |
| 05 | — | 213342 | — | OR |