Individual
MRS. JESSICA MARIE SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
4560 SE INTERNATIONAL WAY, SUITE 101, MILWACKIE, OR 97222
(971) 206-5202
(971) 206-5263
Mailing address
455 GRIZZLY STREET, AUMSVILLE, OR 97325
(518) 390-4910
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
324241
OR
Other
Enumeration date
05/06/2014
Last updated
11/22/2016
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