Individual
SHANNON MADORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD # R&D66, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
160 SW 90TH AVE, PORTLAND, OR 97225-6810
(970) 389-5604
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2896
OR
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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