Individual
MS. SHANNON JOANN HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTL
Contact information
Practice address
924 LAUREL ST, LAKE OSWEGO, OR 97034-4955
(503) 539-1034
Mailing address
924 LAUREL ST, LAKE OSWEGO, OR 97034-4955
(503) 539-1034
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
462770
OR
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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