Individual provider · Type 1 NPI

Pryor Shade

Mental Health Counselor · Portland, OR

NPI number 1013710375 Active

Practice location

1500 NE Irving St Ste 210
Portland, OR 97232-2243

Mailing address

5441 S Macadam Ave Ste 4502
Portland, OR 97239-6106

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XR11056 (OR)

Mental Health Counselor: Definition to come...

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About NPI 1013710375

Pryor Shade's National Provider Identifier is 1013710375, issued on Mar 31, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on May 6, 2025.