Individual
LARISHA SHELBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17970 SW JOHNSON ST APT A, ALOHA, OR 97003-4498
(503) 878-0649
Mailing address
17970 SW JOHNSON ST APT A, ALOHA, OR 97003-4498
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/07/2022
Last updated
02/07/2022
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