Provider Demographics
NPI:1316388259
Name:KNOX, SHANE CHRISTOPHER (MS)
Entity Type:Individual
Prefix:MR
First Name:SHANE
Middle Name:CHRISTOPHER
Last Name:KNOX
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 E 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3380
Mailing Address - Country:US
Mailing Address - Phone:541-868-2004
Mailing Address - Fax:541-868-2003
Practice Address - Street 1:399 E 10TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3380
Practice Address - Country:US
Practice Address - Phone:541-868-2004
Practice Address - Fax:541-868-2003
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist