Healthcare Provider Details

I. General information

NPI: 1356259048
Provider Name (Legal Business Name): DANIEL SHAPIRO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PIER 1 STE 204
ASTORIA OR
97103-6328
US

IV. Provider business mailing address

10 PIER 1 STE 204
ASTORIA OR
97103-6328
US

V. Phone/Fax

Practice location:
  • Phone: 971-350-3737
  • Fax: 888-971-4017
Mailing address:
  • Phone: 971-350-3737
  • Fax: 888-971-4017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberA15830
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: