Healthcare Provider Details

I. General information

NPI: 1699299875
Provider Name (Legal Business Name): SHAWNAJO MARIE POWERS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W KENT AVE
MISSOULA MT
59801-6772
US

IV. Provider business mailing address

3310 MONROE AVE STE 4
BUTTE MT
59701-3820
US

V. Phone/Fax

Practice location:
  • Phone: 406-541-3277
  • Fax: 406-541-3811
Mailing address:
  • Phone: 406-494-3995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number6614
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number6614
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: