| Doctor Name: | SHANNON MACLEAN |
| NPI Number: | 1376799817 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DO |
| License Number: | DR.0051993 |
| Business Practice Address: | 9040 Reid St # A Joint Base Lewis Mcchord, WA - 984311110 |
| Business Phone Number: | 2539681110 |
| Business Fax Number: | |
| Mailing Address: | 9040 Reid St # A, JOINT BASE LEWIS MCCHORD |
| State: | WA |
| Postal Code: | 984311110 |
| Phone Number: | 2539681110 |
| Fax Number: | |
| NPI Enumeration Date: | 08/15/2008 |
| NPI Last Update Date: | 03/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | DR.0051993 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |