Kelly Shaw, LAC

NPI 1205226107 · on the registry since 2015 · sole proprietor

Practice

Address: 6018 Se Stark St
Portland, OR 97215
Phone: (503) 808-9145
Fax: (503) 808-8085
Organisation at this address: Roots Therapy Nw Llc
Pacnorthwest Counseling
Brightside Coworking Inc
Tabor View Health And Wellness
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 24

Registry record

Primary taxonomy: 171100000X
171100000X
Licence states on file: OR
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2015-01-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon