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Individual

HALEY SHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1904 SE DIVISION ST, PORTLAND, OR 97202-1146
(808) 639-6843
Mailing address
1102 N WATER ST, SILVERTON, OR 97381-1335

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
10/05/2012
Last updated
10/05/2012
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