| Dr. Carlene Shultz, P.c. | |
|
1060 Leffelle St Se Salem OR 97302-2969 | |
| (503) 581-6032 | |
| Not Available |
| Full Name | Dr. Carlene Shultz, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 1060 Leffelle St Se, Salem, Oregon |
| Authorized Official Name and Position | Carlene Shultz (PRESIDENT) |
| Authorized Official Contact | 5035816032 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Carlene Shultz, P.c. 1060 Leffelle St Se Salem OR 97302-2969 Ph: (503) 581-6032 | Dr. Carlene Shultz, P.c. 1060 Leffelle St Se Salem OR 97302-2969 Ph: (503) 581-6032 |
| NPI Number | 1386194181 |
|---|---|
| Provider Enumeration Date | 10/05/2016 |
| Last Update Date | 10/05/2016 |
| Medicare PECOS PAC ID | 9638454168 |
|---|---|
| Medicare Enrollment ID | O20170324002118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386194181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1510 (Oregon) | Primary |
| Provider Name | Carlene K Shultz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063515476 PECOS PAC ID: 6406752781 Enrollment ID: I20031209000082 |
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