Individual
SHELLEY RATTERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1215 SW 18TH AVE, PORTLAND, OR 97205-1711
(503) 756-2586
Mailing address
1215 SW 18TH AVE, PORTLAND, OR 97205-1711
(503) 756-2586
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3122
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
291127
MANAGED HLTH NETWORK
OR
Enumeration date
05/06/2007
Last updated
07/08/2007
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