Individual
SHAWNNA TREVETTE VAN SICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
707 SW 37TH ST, PENDLETON, OR 97801-3605
(541) 276-3374
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(971) 364-0611
(971) 364-0610
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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