Provider Demographics
NPI:1215709043
Name:QUIGLEY, SHAUNTEL
Entity type:Individual
Prefix:
First Name:SHAUNTEL
Middle Name:
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAUNTEL
Other - Middle Name:
Other - Last Name:RODGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16830 SW TIMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-7850
Mailing Address - Country:US
Mailing Address - Phone:541-613-6204
Mailing Address - Fax:
Practice Address - Street 1:16830 SW TIMBERLAND DR
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-7850
Practice Address - Country:US
Practice Address - Phone:541-613-6204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician