Individual
SHANNON HIETSCHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
16180 SE SUNNYSIDE RD STE 204, HAPPY VALLEY, OR 97015
(503) 582-4600
(503) 582-4650
Mailing address
16180 SE SUNNYSIDE RD STE 204, HAPPY VALLEY, OR 97015-6302
(503) 582-4600
(503) 582-4650
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
61227
OR
Other
Enumeration date
06/03/2009
Last updated
07/31/2018
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