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1508110974
KIRK M SHEPARD
PORTLAND, OR
NPI
1508110974
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OR C4136)
Enumeration Date
2012-11-06
Last Update Date
2016-05-19
Business Address
-- KIRK M SHEPARD LPC
2100 NE BROADWAY #333
PORTLAND, OR 97232
Phone number: 503-498-8102
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Mailing Address
-- KIRK M SHEPARD LPC
2100 NE BROADWAY #333
PORTLAND, OR 97232
Phone number: 503-498-8102
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