Individual ProviderAndrea Renee ShepherdSocial WorkerBehavioral Health & Social Service ProvidersPractice Address3415 SE Powell Blvd, Portland, OR 97202-3371(503) 234-9591PECOS EnrollmentBased on the most recent information from CMS, provider Andrea Renee Shepherd 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 yesterday at 12:57 PM.Profile DetailsProvider ID1346516911Provider TypeIndividualFull NameShepherd, Andrea ReneeGenderFemaleSole ProprietorNoEnumeration Date3/28/2012Last Updated11/2/2021Contact InformationPractice LocationPractice Address3415 SE Powell Blvd, Portland, OR 97202-3371Phone(503) 234-9591FaxUnlisted FaxMailing LocationMailing Address3415 SE Powell Blvd, Portland, OR 97202-3371Phone(503) 234-9591FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense7810OregonCode101Y00000XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerOregon