Healthcare Provider Details

I. General information

NPI: 1033681077
Provider Name (Legal Business Name): HYON KNORR SHAFFER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2018
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11160 HIGHWAY 62
EAGLE POINT OR
97524-8025
US

IV. Provider business mailing address

PO BOX 228
ROUND MOUNTAIN CA
96084-0228
US

V. Phone/Fax

Practice location:
  • Phone: 541-773-3863
  • Fax:
Mailing address:
  • Phone: 530-337-6244
  • Fax: 530-337-5791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number27704
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH8366
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: