Individual
SHANNON SCRIVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1420 NE MABLE CT, BEND, OR 97701-3722
(541) 680-2001
Mailing address
1420 NE MABLE CT, BEND, OR 97701-3722
(541) 680-2001
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/08/2014
Last updated
04/21/2014
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