Organization
148835
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RSHAFFER E SHAFFER LCSW (MEMBER)
(805) 657-0097
Entity
Organization
Contact information
Practice address
529 SE GRAND AVE, PORTLAND, OR 97214-2232
(971) 270-0468
Mailing address
529 SE GRAND AVE, PORTLAND, OR 97214-2232
(971) 270-0468
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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