Individual
SHANNON A CARSLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
200 SE HAILEY AVE STE 105106, PENDLETON, OR 97801-3073
(541) 429-8844
(541) 429-8822
Mailing address
PO BOX 882, PENDLETON, OR 97801-0882
(541) 429-8844
(541) 429-8822
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
20-CRM-203
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-CRM-203
MHACBO
OR
Enumeration date
11/15/2021
Last updated
11/15/2021
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