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SHANTEL AZURE FULLER
NPI 1629240288
Counselor - Addiction (Substance Use Disorder) in Gresham, OR

Active since March 24, 2008
400 NE 7TH ST, GRESHAM, OR 97030(503) 661-5455 Get Directions Write a Review

NPPES record last updated: March 24, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shantel Azure Fuller NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANTEL AZURE FULLER (NPI 1629240288) is an individual addiction (substance use disorder) provider in Gresham, Oregon and active in the NPI registry since March 2008.

NPPES Registry Identity

NPI1629240288
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameSHANTEL AZURE FULLER
Location Address400 NE 7TH STGresham, OR 97030-5604
Mailing Address10625 Se 362nd Ave Unit C8Boring, OR 97009-9746 · (503) 313-6641
Phone(503) 661-5455
Sole ProprietorYes
Enumeration DateMarch 24, 2008
✔ NPI 1629240288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
400 NE 7TH ST, Gresham, OR 97030
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Other Names 1

Former Name (1)Shantel Azure Stone

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MATTHEW JOSEPH BARTOLOTTI LSCW
Social Worker (Clinical)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 489-2236
LAURIE ANNE RICKEN B.A.
Counselor (Mental Health)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455
RACHEL TOLON
Case Manager/Care Coordinator
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455
DONNA MARIE ANDERSON MSW, QMHP
Social Worker (Clinical)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455
MARY KATHLEEN BOWER MA
Counselor (Mental Health)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455
KEVIN MAHON
Counselor (Mental Health)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455
LAURA A NEUMANN
Counselor (Addiction (Substance Use Disorder))
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 841-4216
ALYSSA WIRTHLIN
Social Worker (Clinical)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shantel Fuller's NPI number?

The NPI number for Shantel Fuller is 1629240288. It was assigned to this individual provider in the NPPES registry on March 24, 2008. The provider is also known as Shantel Azure Stone.

Where is Shantel Fuller located?

Shantel Fuller practices at 400 NE 7th St, Gresham, OR 97030. The listed phone number is (503) 661-5455.

What is Shantel Fuller's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Shantel Fuller was last updated on March 24, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.