Shantel Azure Fuller in Gresham - Addiction (substance Use Disorder)
Shantel Azure Fuller - NPI 1629240288
Shantel Azure Fuller is a Addiction (substance Use Disorder) in Gresham, Oregon. Shantel Azure Fuller practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Shantel Azure Fuller is 1629240288. The last update date is 2008-03-24.
Shantel Azure Fuller's current location address is 400 Ne 7th St, Gresham, Oregon. You can contact this provider via phone number 5036615455. The mailing address for Shantel Azure Fuller is 400 Ne 7th St, Gresham, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shantel Azure Fuller |
|---|---|
| Address | 400 Ne 7th St, Gresham, Oregon |
| Phone Number | 5036615455 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1629240288 |
|---|---|
| Provider Enumeration Date | 2008-03-24 |
| Last Updated Date | 2008-03-24 |
Provider Mailing Address Detail
| Address | 400 Ne 7th St |
|---|---|
| City | Gresham |
| State | Oregon (OR) |
| Post Code | 970305604 |
| Phone Number | 5036615455 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
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Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Shantel Azure Fuller by the Centers for Medicare & Medicaid Services?
The Shantel Azure Fuller has been issued the NPI (National Provider Identifier) 1629240288, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Shantel Azure Fuller?
The Shantel Azure Fuller is situated at 400 Ne 7Th St, in the city of Gresham, state of OR, with the zip code 970305604.
What is Shantel Azure Fuller's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Shantel Azure Fuller is Addiction (substance Use Disorder), and the taxonomy classification code that categorizes this area of expertise is 101Ya0400X.
On what date did Shantel Azure Fuller receive its 1629240288 assignment from the Centers for Medicare & Medicaid Services?
The Shantel Azure Fuller was assigned its 1629240288 on 2008-03-24, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Shantel Azure Fuller, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Shantel Azure Fuller, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2008-03-24.
NPI Number: 1417950320
Address: 1395 Center Drive, D7-6a, Box 100416, Gainesville, FL