Shannon Park, LCSW

NPI 1194851808 · on the registry since 2007 · sole proprietor

Practice

Address: 145 S, Holly Street
Suite A
Medford, OR 97501
Phone: (541) 773-5664
Fax: (541) 773-5667
Organisation at this address: Craniosacral Therapy
Inspired Wellness Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 4

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: OR
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2012-08-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon