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Individual

SHANNON KIMBERLY LEWIS

Active
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Individual

SHANNON KIMBERLY LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A95971
CA
207RG0100X
Gastroenterology Physician
Primary
MD153467
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A959710
CA
05
1780888446
WA
05
500635251
OR
Enumeration date
06/14/2007
Last updated
11/19/2024
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