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Individual

DOROTHY SHANNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNM, NP

Contact information

Practice address
1755 COBURG RD, BLDG 1, SUITE 2, EUGENE, OR 97401-4982
(541) 984-3000
(541) 485-7266
Mailing address
1755 COBURG RD, BLDG 1, SUITE 2, EUGENE, OR 97401-4982
(541) 984-3000
(541) 485-7266

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
080045016N5
OR
363LW0102X
Women's Health Nurse Practitioner
Primary
080045015
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R165420
MEDICARE PTAN
OR
Enumeration date
10/12/2006
Last updated
02/01/2013
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