Individual
SHANNON MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 LANCASTER DRIVE NE, SALEM, OR 97305
(503) 370-4313
Mailing address
1128 34TH AVE NW, SALEM, OR 97304-2206
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H3692
OR
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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