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Individual

SHAYNA CARTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
1217 NE BURNSIDE RD, BUILDING B, SUITE 401, GRESHAM, OR 97030-6722
(503) 666-8832
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
060305
OR
101YP2500X
Professional Counselor
Primary
C2072
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
164936
OR
Enumeration date
11/17/2008
Last updated
11/17/2008
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