Provider Demographics
NPI:1508588641
Name:CHOIN, SHAWNA D (CADC I)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:D
Last Name:CHOIN
Suffix:
Gender:F
Credentials:CADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 SW 4TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MADRAS
Mailing Address - State:OR
Mailing Address - Zip Code:97741-9629
Mailing Address - Country:US
Mailing Address - Phone:541-475-4822
Mailing Address - Fax:541-475-7257
Practice Address - Street 1:850 SW 4TH ST STE 201
Practice Address - Street 2:
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741-9629
Practice Address - Country:US
Practice Address - Phone:541-475-4822
Practice Address - Fax:541-475-7257
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19-01-16101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)