Individual
SHANNON THURSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
24850 SE STARK ST STE 200, GRESHAM, OR 97030-8320
(503) 491-9444
Mailing address
24850 SE STARK ST STE 200, GRESHAM, OR 97030-8320
(503) 491-9444
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
10009305
OR
367A00000X
Advanced Practice Midwife
Primary
10009305
OR
Other
Enumeration date
06/07/2023
Last updated
08/14/2023
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