Individual
SHANNON PERNETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANALYST, MINISTER
Contact information
Practice address
407 NE 12TH AVE, SUITE 101, PORTLAND, OR 97232
(503) 234-1493
(503) 234-7220
Mailing address
407 NE 12TH AVE, SUITE 101, PORTLAND, OR 97232
(503) 234-1493
(503) 232-7440
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
—
—
Other
Enumeration date
04/02/2009
Last updated
04/02/2009
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