Individual ProviderSkip ShewellCounselorBehavioral Health & Social Service ProvidersPractice Address631 NE 102nd Ave Ste 104, Portland, OR 97220-4004(510) 289-3412PECOS EnrollmentBased on the most recent information from CMS, provider Skip Shewell does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1124426093Provider TypeIndividualFull NameShewell, SkipGenderMaleSole ProprietorYesEnumeration Date12/9/2014Last Updated8/11/2022Contact InformationPractice LocationPractice Address631 NE 102nd Ave Ste 104, Portland, OR 97220-4004Phone(510) 289-3412FaxUnlisted FaxMailing LocationMailing Address631 NE 102nd Ave Ste 104, Portland, OR 97220-4004Phone(510) 289-3412FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseC3820Oregon