Provider Demographics
NPI:1508181546
Name:STAHL, SHAWNDI L (PT, MPT, NCS)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNDI
Middle Name:L
Last Name:STAHL
Suffix:
Gender:F
Credentials:PT, MPT, NCS
Other - Prefix:
Other - First Name:SHAWNDI
Other - Middle Name:L
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 NW WALL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3200
Mailing Address - Country:US
Mailing Address - Phone:541-389-4321
Mailing Address - Fax:541-389-4420
Practice Address - Street 1:55 NW WALL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-3200
Practice Address - Country:US
Practice Address - Phone:541-389-4321
Practice Address - Fax:541-389-4420
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4245225100000X, 2251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology