1417572033 NPI number — VERONICA SHIU KNIGHT MED MSW LCSW LICSW

Table of content: VERONICA SHIU KNIGHT MED MSW LCSW LICSW (NPI 1417572033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417572033 NPI number — VERONICA SHIU KNIGHT MED MSW LCSW LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNIGHT
Provider First Name:
VERONICA
Provider Middle Name:
SHIU
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MED MSW LCSW LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417572033
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1682
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97207-1682
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-447-6398
Provider Business Mailing Address Fax Number:
833-806-8878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 SW HARRISON ST APT 14A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97201-5382
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-447-6398
Provider Business Practice Location Address Fax Number:
833-806-8878
Provider Enumeration Date:
06/09/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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