Shannon, Kelly
Shannon, Kelly is an individual health care provider with primary practice located at 1597 Sw 53Rd St , Corvallis OR 97333-2630. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Shannon, Kelly can be contacted via phone (541) 757-8844.Contact Information
Primary practice address
1597 Sw 53Rd St
Corvallis OR 97333-2630
Phone: (541) 757-8844
Fax: (541) 754-9810
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4059AT | Oregon |
Profile Details
| NPI number | 1760937510 |
|---|---|
| LBN Legal business name | Shannon, Kelly |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 22nd, 2016 |
| Last updated | Aug 22nd, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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