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Contact Information

JOHN P SHANNON, MD
301 W POPLAR
SUITE 210
WALLA WALLA, WA99362
 Phone: 509-522-5825
 Fax: 509-529-3512
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JOHN P SHANNON · (Male)

NPI Number 1982610903
Status Active
Credentials MD
Entity Individual
Enumeration date 07/31/2006
Last updated 03/31/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • WA License # 15136
  • WA Medicaid 1696004
Hospital affiliation(s)
  • PROVIDENCE ST MARY MEDICAL CENTER - (Acute Care)
    401 W POPLAR ST
    WALLA WALLA, WA 99362
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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