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General NPI Number Information
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NPI Number | 1790739043
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Entity Type | Individual
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Provider Name | SHELBY N TWETO DC
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Gender | Female
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 04/04/2022
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Provider Practice Location Address
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Address Line | 1615 NW 23RD AVE STE 2
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City | PORTLAND
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State | OR
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Zip | 97210-2563
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Country | US
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Telephone | 503-223-8719
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Fax |
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Provider Business Mailing Address
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Address Line | 1875 SE EXETER DR
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City | PORTLAND
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State | OR
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Zip | 97202-9009
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Country | US
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Telephone | 406-529-4398
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5155
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License Number State | OR
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