Individual
DR. PETER SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
PO BOX 12444, PORTLAND, OR 97212-0444
(503) 704-1000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY60116196
WA
Other
Enumeration date
11/09/2010
Last updated
11/09/2010
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