Provider Demographics
NPI:1033527759
Name:DELNERO, SHANNON ELEANOR (DC)
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:ELEANOR
Last Name:DELNERO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:SHANNON
Other - Middle Name:ELEANOR
Other - Last Name:GRAHAM-ARIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:15120 NE NORTH SHORE RD
Mailing Address - Street 2:
Mailing Address - City:TAHUYA
Mailing Address - State:WA
Mailing Address - Zip Code:98588
Mailing Address - Country:US
Mailing Address - Phone:360-649-5978
Mailing Address - Fax:
Practice Address - Street 1:200 BETHEL RD
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366
Practice Address - Country:US
Practice Address - Phone:360-876-4171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor