Individual
GEORGE B. SHANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 NE MOTHER JOSEPH PL, SUITE 110, VANCOUVER, WA 98664-3299
(360) 254-6161
(360) 449-1146
Mailing address
200 NE MOTHER JOSEPH PL, SUITE 210, VANCOUVER, WA 98664-3299
(360) 254-6161
(360) 449-1139
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD23720
OR
207T00000X
Neurological Surgery Physician
MD40839
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286789
—
OR
05
—
8295388
—
WA
Enumeration date
05/24/2006
Last updated
10/10/2007
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