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General NPI Number Information
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NPI Number | 1598669939
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Entity Type | Individual
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Provider Name | SHANNON ELIZABETH RONDEAU RN
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Gender | Female
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 111 SW NAITO PKWY STE 200
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City | PORTLAND
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State | OR
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Zip | 97204-3512
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Country | US
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Telephone | 503-208-5061
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Fax | 833-260-2594
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Provider Business Mailing Address
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Address Line | 111 SW NAITO PKWY STE 200
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City | PORTLAND
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State | OR
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Zip | 97204-3512
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Country | US
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Telephone | 503-208-5061
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Fax | 833-260-2594
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 056554-21
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 056554-21
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License Number State | NH
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