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NPI Code Detail

MEDICARE: SHANNON DAWNEL GARCIA

MEDICARE: SHANNON DAWNEL GARCIA
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
1101YM0800XMental Health Counselor25-QMHP-R-3596OR

General Provider Information

NPI Number : 1265325013
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON DAWNEL GARCIA
Provider Business Mailing Address
First Line : 6835 N WALL AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97203-5631
Country : US
Telephone Number : 971-570-4825
Fax Number :
Provider Business Practice Location Address
First Line : 239 NE LINCOLN ST
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-3066
Country : US
Telephone Number : 971-238-4408
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2025
Last Update Date : 05/30/2025

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Directions to “ SHANNON DAWNEL GARCIA ” Practice Location

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