Shannon Marie Dalley, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3620 Issued in OR

Practice address

15935 SW 146TH Ave
Tigard, OR 97224-1380

Phone

(360) 602-2563

NPI assigned

Jan 24, 2021

Last updated

Oct 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr. Elom Amuzu LLC

  • Clinical Psychologist
  • Homewood, IL
  • NPI 1508470774
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1447840301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15935 SW 146TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972241380",
            "telephone_number": "978-996-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15935 SW 146TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972241380",
            "telephone_number": "360-602-2563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2148 N 86th St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981034111",
            "country_code": "US",
            "telephone_number": "978-996-9521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALLEY",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-24",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61053793",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Afton Lee Daebney
• Laura L Dahl, MD
• Sophia Grace Dahlstrom
• Zoey Louise Dahme
• Miranda Daley
• Mary M Dalton, MASSAGE THERAPY
• Martha Ann Damato, LMT
• Alla Dancu, RN BSN
• Ashley J Daniel
• J Spenser Daniel

• Clinical Psychologist in Tigard, OR
• Providers in Tigard, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.