person
Shantel Azure Fuller
Addiction (Substance Use Disorder) Counselor in Gresham, Oregon
NPI 1629240288

Shantel Azure Fuller is an Addiction (Substance Use Disorder) Counselor based in Boring, OR and is specialized in Addiction (Substance Use Disorder). Shantel Azure Fuller practices in Gresham, OR. The NPI Number for Shantel Azure Fuller is 1629240288 and holds a License No. (Oregon).

The current practice location address for Shantel Azure Fuller is 400 Ne 7Th St, Gresham, OR and can be reached out via phone at 503-661-5455.

Location: 400 Ne 7Th St, Gresham, OR, 97009-9746
person
Provider Profile Details
NPI Number
1629240288
Provider Name
Shantel Azure Fuller
Credential
Provider Entity Type
Individual
Gender
Female
Address
400 Ne 7Th St, Gresham, OR, 97009-9746
Phone Number
503-661-5455
Fax Number
Provider Enumeration Date
03/24/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
400 Ne 7Th St
City
State
Zip
97030-5604
Phone Number
503-661-5455
Fax Number
person
Provider Business Mailing Address Details
Address
400 Ne 7Th St
City
State
Zip
97030-5604
Phone Number
503-661-5455
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
()
Definition
Definition to come...
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