Individual
SHANNON ALFONSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C
Contact information
Practice address
1015 25TH ST SE, SALEM, OR 97301-5049
(971) 930-4318
Mailing address
15569 SW WREN LN, BEAVERTON, OR 97007-9274
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202002775NP-PP
OR
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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