Shanon Anne Alexander, MA,LMFT

Individual provider Active NPI Marriage & Family Therapist · Portland, OR

NPI 1508991100 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1508991100
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
T0427 (OR)
Practice address
1500 NE Irving St
Suite 250
Portland, OR 97232-2243
Phone
(503) 233-4356
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
T0427ORMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T0427 OR Yes

Addresses

Primary practice location

1500 NE Irving St
Suite 250
Portland, OR 97232-2243

Mailing address

3113 NW Ashland Dr
Beaverton, OR 97006-4664
Phone (503) 531-9607

Other providers in Portland, OR

All providers in Portland, OR · Marriage & Family Therapist in Oregon

Sources for this page

Verify at the official NPI Registry.