Healthcare Provider Details

I. General information

NPI: 1184449431
Provider Name (Legal Business Name): ZUNGE AND NOXBY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CENTERPOINTE DR STE 400
LAKE OSWEGO OR
97035-8661
US

IV. Provider business mailing address

640 W REPUBLIC RD STE 108
SPRINGFIELD MO
65807-5816
US

V. Phone/Fax

Practice location:
  • Phone: 174-353-9480
  • Fax:
Mailing address:
  • Phone: 425-678-3582
  • Fax: 417-356-8800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SHANNON EATON
Title or Position: OWNER/PRESCRIBER
Credential: PMHNP-BC
Phone: 417-353-9480