Individual
MRS. SHANNON ELIZABETH WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
257 SW MADISON AVE STE 230, CORVALLIS, OR 97333-4924
(801) 560-0424
Mailing address
257 SW MADISON AVE STE 230, CORVALLIS, OR 97333-4924
(801) 560-0424
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
113907043902
UT
106H00000X
Marriage & Family Therapist
Primary
T1978
OR
Other
Enumeration date
04/26/2018
Last updated
09/13/2024
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