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General NPI Number Information
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NPI Number | 1336739325
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Entity Type | Individual
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Provider Name | SHELBY NICHOLE RUBINO MAQMHP
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Gender | Female
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Dates
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Enumeration Date | 01/22/2021
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 414 N MERIDIAN ST
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City | NEWBERG
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State | OR
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Zip | 97132-2697
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Country | US
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Telephone | 503-554-2390
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Fax |
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Provider Business Mailing Address
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Address Line | 414 N MERIDIAN ST
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City | NEWBERG
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State | OR
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Zip | 97132-2697
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Country | US
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Telephone | 503-554-2390
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4053
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License Number State | OR
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