Provider Demographics
NPI:1407964190
Name:LAMBORN, SHAWNIE L (DC)
Entity Type:Individual
Prefix:MS
First Name:SHAWNIE
Middle Name:L
Last Name:LAMBORN
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 1:8086 S YALE AVE
Mailing Address - Street 2:# 310
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-9003
Mailing Address - Country:US
Mailing Address - Phone:918-630-5657
Mailing Address - Fax:
Practice Address - Street 1:8086 S YALE AVE # 310
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-9003
Practice Address - Country:US
Practice Address - Phone:918-630-5657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1407964190OtherCOMMERCIAL INSURANCE CO.