Individual
SHAWN AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6449 SE 128TH AVE, PORTLAND, OR 97236-4652
(503) 726-3796
Mailing address
10313 SW 69TH AVE, TIGARD, OR 97223-9103
(503) 726-1710
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OR
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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