Individual
SHANNA MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCN
Contact information
Practice address
6576 SW FIRLOCK WAY APT 8, PORTLAND, OR 97223-7986
(478) 396-6572
Mailing address
6576 SW FIRLOCK WAY APT 8, PORTLAND, OR 97223-7986
(478) 396-6572
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
OR
Other
Enumeration date
04/29/2022
Last updated
04/29/2022
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