Gabriel Shannon, LPC
Counselor, Professional in Portland, OR. Individual provider (NPI-1).
NPI number1063644151
StatusActive
Last updated in NPPESDec 16, 2013
Details
- NPI
- 1063644151
- Entity type
- Individual (NPI-1)
- Name
- Gabriel Shannon
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 21, 2009
- Last updated
- Dec 16, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | C3300 | OR | Yes |
Practice location
605 Se Cesar E Chavez BlvdPortland, OR 97214-3216
Phone 503-231-7480
Mailing address
605 Se Cesar E Chavez BlvdPortland, OR 97214-3216
Phone 503-231-7480
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