MEDICARE: RAY A. SHELLMIRE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	2376	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	167863 SC	OTHER	OR	OMAP

General Provider Information

NPI Number	:	1043428386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAY A. SHELLMIRE LCSW

Provider Business Mailing Address
First Line	:	872 NE 166TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97230-6164
Country	:	US
Telephone Number	:	503-288-2767
Fax Number	:	503-288-2767

Provider Business Practice Location Address
First Line	:	4134 N VANCOUVER AVE
Second Line	:	SUITE 102
City	:	PORTLAND
State	:	OR
Zip	:	97217-2900
Country	:	US
Telephone Number	:	503-331-2548
Fax Number	:	503-331-2549

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1518226216 — MR. LEONARD CLARK CERTIFIED ALCOHOL &
Practice Location Address:

4134 N. VANCOUVER AVE., SUITE 303C
PORTLAND, OR
97217-2900

Practice Phone: 503-593-7764
Practice Fax:

1639430747 — REACHING IN SERVING KIDS
Practice Location Address:

4134 N VANCOUVER AVE , SUITE 303C
PORTLAND, OR
97217-2900

Practice Phone: 503-593-7764
Practice Fax: 503-249-2047

1124446752 — MS. LORENE MARIE CALLAHAN MSW
Practice Location Address:

4134 N VANCOUVER AVE
PORTLAND, OR
97217-2900

Practice Phone: 503-331-2548
Practice Fax:

1104246909 — SHERRILYNN BLANTON
Practice Location Address:

4134 N VANCOUVER AVE STE 102
PORTLAND, OR
97217-2900

Practice Phone: 503-331-2548
Practice Fax: 503-331-2549

1336342443 — JOANNE GORHAM PT
Practice Location Address:

1130 NW 22ND AVE , SUITE 200
PORTLAND, OR
97210-2900

Practice Phone: 503-413-8988
Practice Fax: 503-274-4815

1538627278 — WEST WHARTON COUNTY HOSPITAL DISTRICT
Practice Location Address:

221 CEDAR DR
PORTLAND, TX
78374-2900

Practice Phone: 361-643-1888
Practice Fax: 361-777-3419

Directions to “ RAY A. SHELLMIRE LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.