Individual
SHANNON MCGRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
960 S BROADWAY AVE STE 200, BOISE, ID 83706-3667
(208) 433-9211
(208) 433-9241
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5422
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609375187
—
ID
Enumeration date
02/09/2018
Last updated
04/20/2018
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