Individual
KENDRA SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1160 LIBERTY ST SE, SALEM, OR 97302-4143
(503) 391-9762
(503) 315-2091
Mailing address
1160 LIBERTY ST SE, SALEM, OR 97302-4143
(503) 391-9762
(503) 315-2091
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201809384
OR
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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