Individual
RYLAN SHOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10635 NE FARGO ST, PORTLAND, OR 97220-2758
(207) 251-2504
Mailing address
10635 NE FARGO ST, PORTLAND, OR 97220-2758
(716) 795-2687
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LF61020407
WA
Other
Enumeration date
10/04/2017
Last updated
06/07/2022
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