Sandra L. Shulmire, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

#1186 Issued in OR

Practice address

13831 NW Cornell Rd
Suite 101
Portland, OR 97229-5485

Phone

(503) 645-2944

Fax

(503) 645-2944

NPI assigned

Jul 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1811903263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13831 NW CORNELL RD",
            "address_2": "SUITE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295485",
            "telephone_number": "503-645-2944",
            "fax_number": "503-645-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13831 NW CORNELL RD",
            "address_2": "SUITE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295485",
            "telephone_number": "503-645-2944",
            "fax_number": "503-645-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULMIRE",
        "first_name": "SANDRA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "#1186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077730",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN PIN#",
            "identifier": "021753",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS MHS#",
            "identifier": "480038",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Shuey, RN
• Hayley Shugart, APRN
• Barry D Shulak, D.C.
• Katie Barton Shuler, MS OTR/L
• Malvina Shulik, RDH
• David H Shultis, LPC
• Olga Shults, LMT
• William Thomas Shults I, MD
• Daniel Louis Shultz
• Lisa Ann Shultz, DSOM, L.AC., LMT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.