Provider Demographics
NPI:1124271754
Name:GRUENER, SHAUNA LEANNE (MAT)
Entity type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:LEANNE
Last Name:GRUENER
Suffix:
Gender:F
Credentials:MAT
Other - Prefix:MISS
Other - First Name:SHAUNA
Other - Middle Name:LEANNE
Other - Last Name:NEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38730 DEXTER RD
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:OR
Mailing Address - Zip Code:97431-9797
Mailing Address - Country:US
Mailing Address - Phone:541-937-2307
Mailing Address - Fax:
Practice Address - Street 1:37875 JASPER LOWELL RD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:OR
Practice Address - Zip Code:97438-9751
Practice Address - Country:US
Practice Address - Phone:541-747-1235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health