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Individual

DR. DENA LIANE SHEHAB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
1308 NW 20TH AVE, SUITE 12, PORTLAND, OR 97209-1607
(503) 709-8503
Mailing address
2244 NE 8TH AVE, PORTLAND, OR 97212-3803
(503) 709-8503

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1746
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
J9110 01
PACIFICSOURCE PROVIDER #
OR
Enumeration date
01/12/2007
Last updated
07/08/2007
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