Individual
PATRICK WALTER SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 SW KINKADE, BOARDMAN, OR 97818
(541) 481-2911
(541) 481-2006
Mailing address
PO BOX 469, HEPPNER, OR 97836-0469
(541) 676-9161
(541) 676-5662
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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