JOHN REZENDE-SHALOM
NPI 1699437806
Counselor - Mental Health in Portland, OR
Active since October 06, 2021
About John Rezende-shalom NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN REZENDE-SHALOM (NPI 1699437806) is an individual mental health provider in Portland, Oregon, licensed in Oregon (21-QMHA-R-1569) and active in the NPI registry since October 2021.
NPPES Registry Identity
NPI1699437806
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJOHN REZENDE-SHALOM
Location Address33 NW BROADWAYPortland, OR 97209-3580
Mailing Address232 Nw 6th AvePortland, OR 97209-3609 · (503) 294-1681
Phone(503) 228-7619
Sole ProprietorNo
Enumeration DateOctober 6, 2021
NPPES CertifiedOctober 6, 2021
✔ NPI 1699437806 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OR · 21-QMHA-R-1569
33 NW BROADWAY, Portland, OR 97209
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.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1699437806, enumerated as an "individual" on October 06, 2021.
The provider is located at 33 NW BROADWAY PORTLAND, OR 97209 and the phone number is (503) 228-7619.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
