Healthcare Provider Details

I. General information

NPI: 1316388259
Provider Name (Legal Business Name): SHANE CHRISTOPHER KNOX M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 2ND AVE STE 104E
EUGENE OR
97401-2452
US

IV. Provider business mailing address

400 E 2ND AVE STE 104E
EUGENE OR
97401-2452
US

V. Phone/Fax

Practice location:
  • Phone: 541-246-9686
  • Fax: 458-221-9016
Mailing address:
  • Phone: 541-246-9686
  • Fax: 541-868-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: