Individual
SHANE A MARX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6200 POPLAR LN, INDEPENDENCE, OR 97351-9659
(503) 999-3833
Mailing address
6200 POPLAR LN, INDEPENDENCE, OR 97351-9659
(503) 999-3833
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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