NPI 1205446663

Vivian June Shaw, CRM

Practitioner Prevention Professional Pendleton, OR

Practice location

Address: 46314 Timine Way, Pendleton, OR 97801-9417
Phone: (541) 966-9830
Fax: (541) 240-8754
Mailing address: PO Box 160, Pendleton, OR 97801-0160

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 20-CRM-179 (OR)

Other Prevention Professional providers in Oregon →

Registry record

NPI: 1205446663
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Jul 2020
Record last updated: 31 Jul 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.