FREDERICK SHANNON

PORTLAND, OR
NPI1245168657
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: OR  A824721)
Enumeration Date2026-05-13
Last Update Date2026-05-13
Business Address
FREDERICK SHANNON
2130 SW JEFFERSON ST STE 200
PORTLAND, OR 97201-7710
Phone number: 971-266-6910
Mailing Address
FREDERICK SHANNON
5541 SE HENDERSON ST
PORTLAND, OR 97206-8232
Phone number: 413-262-3228
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