Provider Demographics
NPI:1881567311
Name:SHALHOUT, SONIA Z (MA, MFTA)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:Z
Last Name:SHALHOUT
Suffix:
Gender:F
Credentials:MA, MFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5441 S MACADAM AVE STE R
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3822
Mailing Address - Country:US
Mailing Address - Phone:971-238-9244
Mailing Address - Fax:
Practice Address - Street 1:5441 S MACADAM AVE STE R
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3822
Practice Address - Country:US
Practice Address - Phone:971-238-9244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR12068106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist