Provider Demographics
NPI:1346634771
Name:OLIVER, SHAWNA M (LCSW)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:M
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5943 NE POHLMAN DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6051
Mailing Address - Country:US
Mailing Address - Phone:503-953-4937
Mailing Address - Fax:503-642-7574
Practice Address - Street 1:4900 SW GRIFFITH DR
Practice Address - Street 2:239
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-5607
Practice Address - Country:US
Practice Address - Phone:503-953-4937
Practice Address - Fax:503-642-7574
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL59081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical