Individual
SAMUEL SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
24076 SE STARK ST STE 200, GRESHAM, OR 97030-3376
(503) 491-1666
Mailing address
110 SE 65TH AVE, PORTLAND, OR 97215-1324
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
04/09/2019
Last updated
01/03/2022
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