Provider Demographics
NPI:1881355949
Name:SHETLER, BETHANY (CD (CBI))
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:SHETLER
Suffix:
Gender:F
Credentials:CD (CBI)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 FISKE ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-2013
Mailing Address - Country:US
Mailing Address - Phone:503-400-0413
Mailing Address - Fax:
Practice Address - Street 1:134 FISKE ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-2013
Practice Address - Country:US
Practice Address - Phone:503-400-0413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-31
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula