Individual provider · Type 1 NPI

Shadrack Marvin Sandvold, LMT

Specialist · Portland, OR

NPI number 1316008931 Active

Practice location

1954 SE 182nd Ave
Portland, OR 97233-5602

Call (503) 667-8988 Map

Fax (503) 667-8988

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X5239 (OR)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1316008931

Shadrack Marvin Sandvold, LMT's National Provider Identifier is 1316008931, issued on Dec 13, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Portland, OR. The record was last updated on Jul 8, 2007.