Shivack, Michele

Shivack, Michele is an individual health care provider with primary practice located at 11782 Sw Barnes Rd Suite 300, Portland OR 97225-5914. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic is her primary health care specialty. Shivack, Michele can be contacted via phone (503) 906-4323.

Contact Information

Primary practice address
11782 Sw Barnes Rd Suite 300 Portland OR 97225-5914
Phone: (503) 906-4323
Fax: (503) 906-4333
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports 2251S0007X 4108 Oregon
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X 04108 Oregon

Profile Details

NPI number 1184962128
LBN Legal business name Shivack, Michele
Credentials PT,ATC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2013
Last updated Sep 13th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184962128 NPPES
Oregon Other 04108 LICENSE NUMBER

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