Individual
WILLIE SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC I,
Contact information
Practice address
100 SE 160TH AVE APT 107, PORTLAND, OR 97233-3569
(503) 839-4455
Mailing address
100 SE 160TH AVE APT 107, PORTLAND, OR 97233-3569
(503) 839-4455
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14-03-19
OR
Other
Enumeration date
01/02/2015
Last updated
01/02/2015
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