Shull, Justin
Shull, Justin is an sole proprietor health care provider with primary practice located at 11825 Sw Greenburg Rd Ste 208 , Tigard OR 97223. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Shull, Justin can be contacted via phone (503) 608-0801.Contact Information
Primary practice address
11825 Sw Greenburg Rd Ste 208
Tigard OR 97223
Phone: (503) 608-0801
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | C2060 | Oregon |
Profile Details
| NPI number | 1356531750 |
|---|---|
| LBN Legal business name | Shull, Justin |
| Credentials | M.A., LPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 31st, 2007 |
| Last updated | Jun 8th, 2018 - about 6 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 | 1356531750 | NPPES |
| Oregon | MEDICAID | 164936 |
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