Individual
DR. SANDRA L. SHULMIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
13831 NW CORNELL RD, SUITE 101, PORTLAND, OR 97229-5485
(503) 645-2944
(503) 645-2944
Mailing address
13831 NW CORNELL RD, SUITE 101, PORTLAND, OR 97229-5485
(503) 645-2944
(503) 645-2944
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
#1186
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021753
MHN PIN#
OR
05
—
077730
—
OR
01
—
480038
VALUE OPTIONS MHS#
OR
Enumeration date
07/31/2006
Last updated
07/09/2007
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