Provider Demographics
NPI:1396487708
Name:CURRY, SHANNON E
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:E
Last Name:CURRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1538
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-0115
Mailing Address - Country:US
Mailing Address - Phone:541-574-9570
Mailing Address - Fax:541-574-8857
Practice Address - Street 1:1720 34TH ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-9514
Practice Address - Country:US
Practice Address - Phone:541-574-9570
Practice Address - Fax:541-574-8857
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
THW000004179175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist