Provider Demographics
NPI:1750439881
Name:SPAIN, SHEILA DAWN (LMFT)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:DAWN
Last Name:SPAIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14175 SW COUGAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-9419
Mailing Address - Country:US
Mailing Address - Phone:425-418-9515
Mailing Address - Fax:503-601-0049
Practice Address - Street 1:12250 SW 2ND ST STE A
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005
Practice Address - Country:US
Practice Address - Phone:425-418-9515
Practice Address - Fax:503-601-0049
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001180106H00000X
ORT1127106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist