Individual
SHANNON CANNON
Active
Individual
SHANNON CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ML60370885
WA
208800000X
Urology Physician
MD60943485
WA
2088P0231X
Pediatric Urology Physician
Primary
75781
WI
Other
Enumeration date
03/28/2013
Last updated
08/27/2021
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