Provider Demographics
NPI:1487305173
Name:MCGOWAN, SHAUN (PA-C)
Entity type:Individual
Prefix:
First Name:SHAUN
Middle Name:
Last Name:MCGOWAN
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:201 NW MEDICAL LOOP STE 190
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-8835
Mailing Address - Country:US
Mailing Address - Phone:541-677-4319
Mailing Address - Fax:541-677-2294
Practice Address - Street 1:2510 NW EDENBOWER BLVD STE 112
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-8899
Practice Address - Country:US
Practice Address - Phone:541-464-6260
Practice Address - Fax:541-229-0014
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical