Healthcare Provider Details

I. General information

NPI: 1366832461
Provider Name (Legal Business Name): MARIA LIOTTA SHINDLER MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2015
Last Update Date: 01/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 NE CARILLION DR
HILLSBORO OR
97124-8590
US

IV. Provider business mailing address

6201 NE CARILLION DR
HILLSBORO OR
97124-8590
US

V. Phone/Fax

Practice location:
  • Phone: 503-435-9921
  • Fax:
Mailing address:
  • Phone: 503-435-9921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number095006204RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: