Provider Demographics
NPI:1568836146
Name:SHOJINAGA, JASMINE LOUISE (MA)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:LOUISE
Last Name:SHOJINAGA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7537 N ELMORE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-5649
Mailing Address - Country:US
Mailing Address - Phone:503-704-1203
Mailing Address - Fax:
Practice Address - Street 1:7537 N ELMORE AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-5649
Practice Address - Country:US
Practice Address - Phone:503-704-1203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15692235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist