Provider Demographics
NPI:1841937844
Name:DWIGHT, SHARI
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:DWIGHT
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 1:14110 SW ALLEN BLVD APT 88
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-4702
Mailing Address - Country:US
Mailing Address - Phone:541-905-8192
Mailing Address - Fax:
Practice Address - Street 1:16100 NW CORNELL RD STE 290
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-7636
Practice Address - Country:US
Practice Address - Phone:503-342-2778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health