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General NPI Number Information
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NPI Number | 1992643696
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Entity Type | Individual
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Provider Name | SHANNON DIANE CHRISMAN CSWA
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Gender | Female
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 311 SE DORION AVE
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City | PENDLETON
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State | OR
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Zip | 97801-2529
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Country | US
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Telephone | 541-272-1606
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Fax |
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Provider Business Mailing Address
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Address Line | 311 SE DORION AVE
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City | PENDLETON
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State | OR
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Zip | 97801-2529
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Country | US
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Telephone | 541-272-1606
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A15689
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | A15689
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | A15689
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License Number State | OR
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