Individual
TIANZHAN SHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(150) 323-4959
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
247200000X
Other Technician
Primary
ABA-IN-10241091
OR
Other
Enumeration date
10/30/2023
Last updated
02/27/2024
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