# SHEARWATER COUNSELING SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467011577
- **Authorized official:** CARLA FADRIQUELA LCSW (OWNER)
- **Authorized official phone:** (971) 351-0485

## Contact information

- **Practice address:** 510 SW 3RD AVE STE 200, PORTLAND, OR 97204-2507
- **Practice address phone:** (808) 281-4616
- **Practice address fax:** (937) 544-4009
- **Mailing address:** 2980 SW 123RD AVE, BEAVERTON, OR 97005-1325
- **Mailing address phone:** (808) 281-4616
- **Mailing address fax:** (937) 544-4009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 06/12/2019
- **Last updated:** 06/12/2019