Provider Demographics
NPI:1356709448
Name:AHERN, SHEILA KATHRYN (CPE)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:KATHRYN
Last Name:AHERN
Suffix:
Gender:F
Credentials:CPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 SW ALDER ST
Mailing Address - Street 2:STUITE 920
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-3625
Mailing Address - Country:US
Mailing Address - Phone:503-227-6050
Mailing Address - Fax:503-241-4299
Practice Address - Street 1:610 SW ALDER ST
Practice Address - Street 2:STUITE 920
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-3625
Practice Address - Country:US
Practice Address - Phone:503-227-6050
Practice Address - Fax:503-241-4299
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-03
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORBAP-E-10153367174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist