Provider Demographics
NPI:1376826107
Name:ANHORN, SHANNON N (DC)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:N
Last Name:ANHORN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4160 SE DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-869-9521
Practice Address - Street 1:4160 SE DIVISION ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1647
Practice Address - Country:US
Practice Address - Phone:805-208-0266
Practice Address - Fax:888-869-9521
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5000N7111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor