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NPI Code Detail

MEDICARE: SHIFT CONSULTATION LLC

MEDICARE: SHIFT CONSULTATION LLC
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
1106E00000XAssistant Behavior Analyst
2106S00000XBehavior Technician
3103K00000XBehavior Analyst

General Provider Information

NPI Number : 1407677222
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHIFT CONSULTATION LLC
Provider Business Mailing Address
First Line : PO BOX 66760
Second Line :
City : PORTLAND
State : OR
Zip : 97290-6760
Country : US
Telephone Number : 503-550-1245
Fax Number :
Provider Business Practice Location Address
First Line : 10527 SE RAYMOND ST
Second Line :
City : PORTLAND
State : OR
Zip : 97266-3561
Country : US
Telephone Number : 503-550-1245
Fax Number :
Authorized Official
Title or Position : OWNER
Name : NICOLE WILLIFORD
Credential : M. ED, BCBA, LBA
Telephone Number : 503-550-1245
Provider Enumeration Date : 10/23/2024
Last Update Date : 10/23/2024

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Directions to “SHIFT CONSULTATION LLC ” Practice Location

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