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General NPI Number Information
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NPI Number | 1184449431
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Entity Type | Organization
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Legal Business Name | ZUNGE AND NOXBY LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 5 CENTERPOINTE DR STE 400
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-8661
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Country | US
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Telephone | 174-353-9480
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Fax |
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Provider Business Mailing Address
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Address Line | 640 W REPUBLIC RD STE 108
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City | SPRINGFIELD
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State | MO
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Zip | 65807-5816
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Country | US
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Telephone | 425-678-3582
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Fax | 417-356-8800
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Authorized Official
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Title or Position | OWNER/PRESCRIBER
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Name | SHANNON EATON
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Credential | PMHNP-BC
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Telephone | 417-353-9480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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