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1902318074
SHANNON LOFSTROM
PORTLAND, OR
NPI
1902318074
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OR 09003099LPN)
Enumeration Date
2017-10-30
Last Update Date
2017-10-30
Business Address
SHANNON LOFSTROM
324 NW DAVIS ST
PORTLAND, OR 97209-3925
Phone number: 503-226-2203
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Mailing Address
SHANNON LOFSTROM
6628 SW MAYO ST
PORTLAND, OR 97223-1303
Phone number:
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