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Individual

CANDACE LYNN SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
185 N 4TH ST, SAINT HELENS, OR 97051-1535
(503) 438-2180
(503) 366-4526
Mailing address
185 N 4TH ST, SAINT HELENS, OR 97051-1535
(503) 438-2180
(503) 366-4526

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
QMHA-1644
OR
132700000X
Dietary Manager

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1770253387
MENTAL HEALTH CLINICIAN
OR
Enumeration date
09/15/2021
Last updated
10/12/2021
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