Individual
SHANNON THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
2200 4TH ST, BAKER CITY, OR 97814-2615
(541) 523-3646
(541) 523-7602
Mailing address
2200 4TH ST, BAKER CITY, OR 97814-2615
(541) 523-3646
(541) 523-7602
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/20/2010
Last updated
08/20/2010
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