Healthcare Provider Details

I. General information

NPI: 1447175609
Provider Name (Legal Business Name): SHOKOUFEH ALIZADEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 SW CEDAR HILLS BLVD STE 288
BEAVERTON OR
97005-2035
US

IV. Provider business mailing address

10992 NW APPELLATE WAY
PORTLAND OR
97229-8815
US

V. Phone/Fax

Practice location:
  • Phone: 971-727-4445
  • Fax:
Mailing address:
  • Phone: 971-727-4445
  • Fax: 971-727-4445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: