Individual
SHANNA PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1701 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1051
(541) 471-3455
(541) 471-1439
Mailing address
1701 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1051
(541) 471-3455
(541) 471-1439
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA165436
OR
Other
Enumeration date
11/07/2013
Last updated
10/24/2022
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