Individual
AMANDA SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
26000 SE STARK ST, GRESHAM, OR 97030-3300
(503) 491-7350
Mailing address
1930 NW FRONT AVE APT 212, PORTLAND, OR 97209-1849
(414) 699-7736
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
10161465
OR
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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