Individual
SHANNON MARIE HOLYOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
9425 N GENEVA AVE, PORTLAND, OR 97203-2648
(503) 504-5040
Mailing address
9425 N GENEVA AVE, PORTLAND, OR 97203-2648
(503) 504-5040
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
200640590RN
OR
163WP0200X
Pediatric Registered Nurse
200646590RN
OR
Other
Enumeration date
12/22/2009
Last updated
12/22/2009
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