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NPI Code Detail

MEDICARE: DR. SHELLEY PAINE NORTON PH.D

MEDICARE: DR. SHELLEY PAINE NORTON PH.D
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
1103TC0700XClinical Psychologist1027OR

General Provider Information

NPI Number : 1548475734
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHELLEY PAINE NORTON PH.D
Provider Business Mailing Address
First Line : 5525 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97215-1258
Country : US
Telephone Number : 503-239-4475
Fax Number : 503-233-4449
Provider Business Practice Location Address
First Line : 5525 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97215-1258
Country : US
Telephone Number : 503-239-4475
Fax Number : 503-233-4449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2007
Last Update Date : 07/08/2007

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