Individual
DR. SHANNON JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3838 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4416
(253) 212-3430
Mailing address
3838 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4416
(253) 212-3430
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DENT.DE.70004365
WA
1223G0001X
General Practice Dentistry
Primary
DENT.DE.70004365
WA
Other
Enumeration date
06/30/2023
Last updated
08/19/2025
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