Individual
SHAWN LEE THARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330-9695
(541) 990-7108
Mailing address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330-9695
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/16/2017
Last updated
12/16/2017
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