Individual
JOSEPH SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
15390 NW CORNELL RD STE 230, BEAVERTON, OR 97006-5627
(971) 245-6663
(971) 245-6664
Mailing address
10121 SE SUNNYSIDE RD STE 208, CLACKAMAS, OR 97015-5750
(503) 794-0103
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62366
OR
Other
Enumeration date
06/23/2017
Last updated
03/17/2018
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