Individual
SHALENA DAWN HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
2025 SE JEFFERSON ST, MILWAUKIE, OR 97222-7605
(503) 886-9708
(503) 905-6164
Mailing address
2025 SE JEFFERSON ST, MILWAUKIE, OR 97222-7605
(503) 886-9708
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 000917
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500676532
DMAP
OR
Enumeration date
03/28/2007
Last updated
12/01/2016
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