Individual
SHELLY R CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
3723 FAIRVIEW INDUSTRIAL DR SE STE 170, SALEM, OR 97302-1174
(503) 371-1970
(503) 371-0192
Mailing address
3723 FAIRVIEW INDUSTRIAL DR SE STE 170, SALEM, OR 97302-1174
(503) 371-1970
(503) 371-0192
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
05/27/2020
Last updated
05/27/2020
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