Provider Demographics
NPI:1811435043
Name:KARIMBEIK, SHAHIN
Entity type:Individual
Prefix:
First Name:SHAHIN
Middle Name:
Last Name:KARIMBEIK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5014 SE BYBEE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-8320
Mailing Address - Country:US
Mailing Address - Phone:310-295-7770
Mailing Address - Fax:
Practice Address - Street 1:3050 SE DIVISION ST STE 215
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1997
Practice Address - Country:US
Practice Address - Phone:503-622-8964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-08
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OR201392609163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse