Individual
SHANE LODDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
606 MEDICAL PKWY, ENTERPRISE, OR 97828-5140
(541) 426-4524
Mailing address
106 W ALDER ST, ENTERPRISE, OR 97828-1512
(509) 386-9550
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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