Provider Demographics
NPI:1902035033
Name:LEVINE, SHARI LEE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:SHARI
Middle Name:LEE
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 SW TAYLOR ST STE 630
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2506
Mailing Address - Country:US
Mailing Address - Phone:503-797-2709
Mailing Address - Fax:
Practice Address - Street 1:1020 SW TAYLOR ST STE 630
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2506
Practice Address - Country:US
Practice Address - Phone:503-797-2709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTO318106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist