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General NPI Number Information
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NPI Number | 1255804233
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Entity Type | Individual
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Provider Name | SHANNON JEAN LEMAY PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 875 OAK ST SE STE 1080
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City | SALEM
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State | OR
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Zip | 97301-3977
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Country | US
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Telephone | 503-814-1397
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 391
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City | SALEM
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State | OR
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Zip | 97308-0391
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Country | US
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Telephone | 503-814-1397
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Fax | 503-814-1402
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA190334
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License Number State | OR
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