Provider Demographics
NPI:1205156833
Name:BAIRD, SHANNON (CD, IPSP)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:BAIRD
Suffix:
Gender:F
Credentials:CD, IPSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 231033
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97281-1033
Mailing Address - Country:US
Mailing Address - Phone:503-593-0625
Mailing Address - Fax:
Practice Address - Street 1:9054 SW 91ST AVE
Practice Address - Street 2:#9
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6936
Practice Address - Country:US
Practice Address - Phone:503-593-0625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-05
Last Update Date:2010-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula