Individual
SHANNON LA DOUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
945 COLUMBIA ST NE, SALEM, OR 97301-7205
(503) 707-1950
Mailing address
945 COLUMBIA ST NE, SALEM, OR 97301-7205
(503) 707-1950
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202112026NP-PP
OR
Other
Enumeration date
11/19/2021
Last updated
11/19/2021
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