Provider Demographics
NPI:1497064042
Name:BETTERTON SHELMET, ADRIENNE ANN
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:ANN
Last Name:BETTERTON SHELMET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:ANN
Other - Last Name:BETTERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:727 NE 24TH AVE
Mailing Address - Street 2:VOLUNTEERS OF AMERICA INACT
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2222
Mailing Address - Country:US
Mailing Address - Phone:503-228-9229
Mailing Address - Fax:503-228-9558
Practice Address - Street 1:727 NE 24TH AVE
Practice Address - Street 2:VOLUNTEERS OF AMERICA INACT
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2222
Practice Address - Country:US
Practice Address - Phone:503-228-9229
Practice Address - Fax:503-228-9558
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)