Individual
SHANNON LEE DE ANGELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
548 SW 13TH ST, BEND, OR 97702-3184
(541) 388-8459
Mailing address
20295 MARINER DR, BEND, OR 97703-7069
(503) 840-4606
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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