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1477849875
SHANNON C KENNEDY
PORTLAND, OR
NPI
1477849875
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2011-06-23
Last Update Date
2011-06-23
Business Address
-- SHANNON C KENNEDY
1312 SW WASHINGTON ST
PORTLAND, OR 97205-2327
Phone number: 503-535-1150
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Mailing Address
-- SHANNON C KENNEDY
PO BOX 3007
PORTLAND, OR 97208-3007
Phone number:
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