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NPI Code Detail

MEDICARE: PATRICIA RENEE SHIMEK MS

MEDICARE: PATRICIA RENEE SHIMEK MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistOR

General Provider Information

NPI Number : 1215584776
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA RENEE SHIMEK MS
Provider Business Mailing Address
First Line : 1490 SW 21ST TER
Second Line :
City : GRESHAM
State : OR
Zip : 97080-6613
Country : US
Telephone Number : 503-730-2284
Fax Number :
Provider Business Practice Location Address
First Line : 2222 E POWELL BLVD
Second Line :
City : GRESHAM
State : OR
Zip : 97080-1365
Country : US
Telephone Number : 503-669-4300
Fax Number : 503-669-4301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2019
Last Update Date : 08/20/2019

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Directions to “ PATRICIA RENEE SHIMEK MS” Practice Location

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