Shannon Renee Freeman
Individual provider Active NPI Behavior Technician · Sandy, OR
NPI 1780415950 · NPPES record last updated Aug 9, 2024
Key facts
- NPI
- 1780415950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 35900 Chinook St
Sandy, OR 97055-7813 - Phone
- (503) 708-8738
- NPI assigned
- Aug 9, 2024
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
35900 Chinook St
Sandy, OR 97055-7813
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Other providers in Sandy, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.