Healthcare Provider Details

I. General information

NPI: 1528996576
Provider Name (Legal Business Name): SHANNON MARIE MCGILL M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 JEFFERSON ST
EUGENE OR
97405-2555
US

IV. Provider business mailing address

2960 JEFFERSON ST
EUGENE OR
97405-2555
US

V. Phone/Fax

Practice location:
  • Phone: 541-729-9580
  • Fax:
Mailing address:
  • Phone: 541-729-9580
  • Fax:

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: