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General NPI Number Information
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NPI Number | 1437459039
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Entity Type | Individual
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Provider Name | SOFIA SHEPSIS PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 1130 SW MORRISON ST
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City | PORTLAND
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State | OR
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Zip | 97205-2234
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Country | US
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Telephone | 503-912-4060
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Fax |
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Provider Business Mailing Address
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Address Line | 4030 NW RIGGS DR
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City | PORTLAND
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State | OR
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Zip | 97229-8093
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Country | US
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Telephone | 503-912-4060
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2720
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License Number State | OR
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