Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist | 27704 | CA |
Y | 124Q00000X | Dental Hygienist | H8366 | OR |
NPI | 1033681077 |
---|---|
Provider Name | Hyon Knorr Shaffer |
First Address | Round Mountain, CA 96084-0228 |
Second Address | Medford, OR 97504-6139 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2018 |
Last Update Date | 03/02/2022 |