Individual
BRIAN SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1133 NW WALL ST STE 6, BEND, OR 97703-1962
(541) 581-0394
Mailing address
2157 NW QUINCE CT, REDMOND, OR 97756-7657
(541) 581-0394
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C7238
OR
Other
Enumeration date
03/08/2016
Last updated
10/05/2023
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