| Doctor Name: | SHANNEN KNIGHT |
| NPI Number: | 1245669415 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 8910 |
| Business Practice Address: | 1980 Willamette Falls Dr Suite 130 West Linn, OR - 970684668 |
| Business Phone Number: | 5036994160 |
| Business Fax Number: | 8882406551 |
| Mailing Address: | 1980 Willamette Falls Dr, Suite 130 WEST LINN |
| State: | OR |
| Postal Code: | 970684668 |
| Phone Number: | 5036994160 |
| Fax Number: | 8882406551 |
| NPI Enumeration Date: | 11/07/2013 |
| NPI Last Update Date: | 11/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 8910 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |