Provider Demographics
NPI:1255140620
Name:ANDERSON, SHAWNEE R
Entity type:Individual
Prefix:
First Name:SHAWNEE
Middle Name:R
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 NEIL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-9723
Mailing Address - Country:US
Mailing Address - Phone:541-973-1268
Mailing Address - Fax:
Practice Address - Street 1:1001 NEIL CREEK RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-9723
Practice Address - Country:US
Practice Address - Phone:541-973-1268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula