Individual
MRS. SHAWNA DEANNE IVERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MOT OTR L
Contact information
Practice address
290 MOYER LN NW, SALEM, OR 97304
(503) 370-8990
(503) 363-4214
Mailing address
1402 GWINN ST E, MONMOUTH, OR 97361
(503) 510-5814
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1053130
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276082
—
OR
Enumeration date
12/28/2005
Last updated
07/08/2007
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