Provider Demographics
NPI:1861043226
Name:WEST, SHIRLEEN ANN (WIFE/AID & ATTENDANT)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEEN
Middle Name:ANN
Last Name:WEST
Suffix:
Gender:F
Credentials:WIFE/AID & ATTENDANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12669 S.E. ELDERBERRY DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEACH
Mailing Address - State:OR
Mailing Address - Zip Code:97366
Mailing Address - Country:US
Mailing Address - Phone:541-867-3437
Mailing Address - Fax:
Practice Address - Street 1:12669 S.E. ELDERBERRY DRIVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEACH
Practice Address - State:OR
Practice Address - Zip Code:97366
Practice Address - Country:US
Practice Address - Phone:541-867-3437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider