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Shantell Boulware
NPI 1659761435 · on the registry since 2015
Practice
- Address
- 272 Nw Medical Loop Ste E
Roseburg, OR 97471 - Phone
- (541) 440-3532
- Organisation at this address
- Roseburg Therapy Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 31
Registry record
- Primary taxonomy
- 171M00000X
171M00000X
- Licence states on file
- OR
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2015-01-30
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