Provider Demographics
NPI:1164741989
Name:AVIGAL, SHIRA HEATHER (MA LPC)
Entity Type:Individual
Prefix:
First Name:SHIRA
Middle Name:HEATHER
Last Name:AVIGAL
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 SW HAMPTON ST STE 230
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8331
Mailing Address - Country:US
Mailing Address - Phone:503-577-0220
Mailing Address - Fax:
Practice Address - Street 1:6950 SW HAMPTON ST STE 230
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-8331
Practice Address - Country:US
Practice Address - Phone:503-577-0220
Practice Address - Fax:503-200-2975
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health