Mccormick, Shanda Ailene
Mccormick, Shanda Ailene is an individual health care provider with primary practice located at 13470 Sw Farmington Rd , Beaverton OR 97005-2618. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Mccormick, Shanda Ailene can be contacted via phone (503) 644-3311.Contact Information
Primary practice address
13470 Sw Farmington Rd
Beaverton OR 97005-2618
Phone: (503) 644-3311
Fax: (503) 627-0112
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 4675 | Oregon |
Profile Details
| NPI number | 1932181062 |
|---|---|
| LBN Legal business name | Mccormick, Shanda Ailene |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 15th, 2005 |
| Last updated | Nov 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932181062 | NPPES |
| Oregon | MEDICAID | 299951 |
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