Provider Demographics
NPI:1790739043
Name:TWETO, SHELBY N (DC)
Entity Type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:N
Last Name:TWETO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 SE EXETER DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-9009
Mailing Address - Country:US
Mailing Address - Phone:406-529-4398
Mailing Address - Fax:
Practice Address - Street 1:1615 NW 23RD AVE STE 2
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2563
Practice Address - Country:US
Practice Address - Phone:503-223-8719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5155111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor