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MAGDALENE CLARE SHAUGHNESSY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
Mailing address
515 MILLER AVE, NORMAN, OK 73069-5929
(405) 473-3810

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
55241
CA
363A00000X
Physician Assistant
Primary
PA185332
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55241
PHYSICIAN ASSISTANT LICENSE
CA
Enumeration date
02/05/2018
Last updated
01/09/2023
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