Provider Demographics
NPI:1689386195
Name:POWELL, SHEENA BELLE
Entity Type:Individual
Prefix:MS
First Name:SHEENA
Middle Name:BELLE
Last Name:POWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4155 MARKET ST NE APT E
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2063
Mailing Address - Country:US
Mailing Address - Phone:503-932-3251
Mailing Address - Fax:
Practice Address - Street 1:2995 RYAN DR SE STE 200
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-5157
Practice Address - Country:US
Practice Address - Phone:503-932-3251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist