| Anjuli Shah-johnson | |
|
1611 Ne 16th Ave Portland OR 97232-1413 | |
| (773) 991-0103 | |
| Not Available |
| Full Name | Anjuli Shah-johnson |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1611 Ne 16th Ave, Portland, Oregon |
| Authorized Official Name and Position | Anjuli Shah-johnson (OWNER/THERAPIST/BODYWORKER) |
| Authorized Official Contact | 7739910103 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anjuli Shah-johnson 1611 Ne 16th Ave Portland OR 97232-1413 Ph: () - | Anjuli Shah-johnson 1611 Ne 16th Ave Portland OR 97232-1413 Ph: (773) 991-0103 |
| NPI Number | 1043677198 |
|---|---|
| Provider Enumeration Date | 01/20/2016 |
| Last Update Date | 01/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043677198 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | L5990 (Oregon) | Primary |
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