Individual
MICHELLE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8695 SW JACK BURNS BLVD, WILSONVILLE, OR 97070-5797
(512) 250-8800
Mailing address
10301 RANCH ROAD, FM 2222,, APT 435, AUSTIN, TX 78730
(360) 200-5314
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT127515
TX
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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