Individual
JULIA SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4730 SW MACADAM AVE STE 201J, PORTLAND, OR 97239-6417
(503) 707-6549
Mailing address
4730 SW MACADAM AVE STE 201I, PORTLAND, OR 97239-6417
(503) 707-6549
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1074682
OR
225X00000X
Occupational Therapist
OT00004540
WA
Other
Enumeration date
10/18/2007
Last updated
03/17/2018
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