Individual
SHANE JOSEPH GARVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 NE MLK BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
Mailing address
465 SENATE ST NW, SALEM, OR 97304-4644
(503) 734-7051
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
Other
Enumeration date
07/27/2022
Last updated
05/31/2023
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