Individual
SHANIQUA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2559 MERRIMAN RD, MEDFORD, OR 97501-1260
(541) 237-0053
(541) 200-3450
Mailing address
1750 NEBRASKA AVE BLDG A, GRANTS PASS, OR 97527-5700
(541) 956-4943
(541) 295-3085
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/27/2025
Last updated
08/28/2025
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