Shannon Isabelle Vajretti, QMHA
Case Manager/Care Coordinator in Dallas, OR. Individual provider (NPI-1).
NPI number1104598697
StatusActive
Last updated in NPPESOct 28, 2024
Details
- NPI
- 1104598697
- Entity type
- Individual (NPI-1)
- Name
- Shannon Isabelle Vajretti
- Credential
- QMHA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 2, 2021
- Certification date
- Oct 28, 2024
- Last updated
- Oct 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | OR | Yes |
Practice location
182 Sw Academy StDallas, OR 97338-1996
Phone 503-623-9289
Mailing address
5755 Red Leaf Dr S Apt 110Salem, OR 97306-3019
Phone 408-529-3487
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