Provider Demographics
NPI:1629412168
Name:BANERJEE, SHILPI (PHD)
Entity Type:Individual
Prefix:
First Name:SHILPI
Middle Name:
Last Name:BANERJEE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 SE 7TH AVE # 4450
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4157
Mailing Address - Country:US
Mailing Address - Phone:503-352-2661
Mailing Address - Fax:
Practice Address - Street 1:333 SE 7TH AVE # 4450
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4157
Practice Address - Country:US
Practice Address - Phone:503-352-2661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-27
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR30762231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist