SHANTEL FULLER

Counselor - Addiction (Substance Use Disorder)

Active Individual
NPI: 1629240288

Practice Address

400 NE 7TH ST
Gresham, OR 97030

Phone: (503) 661-5455

Specialties

Specialty Code Primary License
Counselor - Addiction (Substance Use Disorder) 101YA0400X Yes -

Frequently Asked Questions

NPI 1629240288 is the National Provider Identifier for SHANTEL FULLER, a Counselor - Addiction (Substance Use Disorder) provider located in Gresham, OR. This NPI was enumerated on March 24, 2008.
SHANTEL FULLER practices at 400 NE 7TH ST, Gresham, OR 97030.

Quick Facts

NPI
1629240288
Type
Individual
Enumerated
Mar 24, 2008
Last Updated
Mar 24, 2008

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