| Shellmire Unlimited, P.c. | |
|
4134 N Vancouver Avenue, Suite 102 Portland OR 97217 | |
| (503) 331-2548 | |
| (503) 331-2549 |
| Full Name | Shellmire Unlimited, P.c. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4134 N Vancouver Avenue, Suite 102, Portland, Oregon |
| Authorized Official Name and Position | Ray Shellmire (CEO) |
| Authorized Official Contact | 5038032309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shellmire Unlimited, P.c. 4134 N Vancouver Avenue, Suite 102 Portland OR 97217 Ph: (503) 331-2548 | Shellmire Unlimited, P.c. 4134 N Vancouver Avenue, Suite 102 Portland OR 97217 Ph: (503) 331-2548 |
| NPI Number | 1659793107 |
|---|---|
| Provider Enumeration Date | 01/16/2014 |
| Last Update Date | 01/16/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659793107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2376 (Oregon) | Primary |
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