MEDICARE: HYON KNORR SHAFFER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	27704	CA
2	124Q00000X	Dental Hygienist	H8366	OR

General Provider Information

NPI Number	:	1033681077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYON KNORR SHAFFER

Provider Business Mailing Address
First Line	:	PO BOX 228
Second Line	:
City	:	ROUND MOUNTAIN
State	:	CA
Zip	:	96084-0228
Country	:	US
Telephone Number	:	530-337-6244
Fax Number	:	530-337-5791

Provider Business Practice Location Address
First Line	:	11160 HIGHWAY 62
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-8025
Country	:	US
Telephone Number	:	541-773-3863
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2018
Last Update Date	:	06/03/2026

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Directions to “ HYON KNORR SHAFFER ” Practice Location

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