Individual
MARTINA ANDREA SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
966 12TH ST SE STE 130, SALEM, OR 97302-2860
(503) 837-6395
Mailing address
966 12TH ST SE STE 130, SALEM, OR 97302-2860
(503) 837-6395
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/18/2025
Last updated
10/08/2025
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