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Individual

SAMUEL SHEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS CHP

Contact information

Practice address
825 NE 20TH AVE STE 330, PORTLAND, OR 97232-1000
(503) 290-1916
Mailing address
4125 N LONGVIEW AVE, PORTLAND, OR 97217-3354
(503) 244-4456

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
10/04/2013
Last updated
10/10/2013
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