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NPI Code Detail

MEDICARE: AMY E SHOREY LCSW

MEDICARE: AMY E SHOREY LCSW
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
11041C0700XClinical Social WorkerL3842OR

General Provider Information

NPI Number : 1942455605
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY E SHOREY LCSW
Provider Business Mailing Address
First Line : 1937 NE SARATOGA ST
Second Line :
City : PORTLAND
State : OR
Zip : 97211-5236
Country : US
Telephone Number : 503-853-9727
Fax Number :
Provider Business Practice Location Address
First Line : 1305 NE FREMONT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97212-2218
Country : US
Telephone Number : 503-853-9727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2008
Last Update Date : 11/22/2008

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Directions to “ AMY E SHOREY LCSW” Practice Location

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