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Individual

MISS KIRSTEN CELANIRE SHANGRAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-5787
Mailing address
777 NW 19TH AVE APT 513, PORTLAND, OR 97209-1397

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60918
OR

Other

Enumeration date
09/07/2017
Last updated
09/07/2017
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