Individual
MR. VIJAY SHANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
10490SW EASTRIDGE STREET, SUITE 110-D, PORTLAND, OR 97225
(503) 297-2257
(503) 297-1787
Mailing address
10490SW EASTRIDGE STREET, SUITE 110-D, PORTLAND, OR 97225
(503) 297-2257
(503) 297-1787
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1281
OR
Other
Enumeration date
12/06/2007
Last updated
12/06/2007
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