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1528175239

NPI Code Detail

MEDICARE: JOHN CHRISTOPHER SHAW MD

MEDICARE: JOHN CHRISTOPHER SHAW MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD00043484	WA
2	207R00000X	Internal Medicine Physician	MD179056	OR
3	208000000X	Pediatrics Physician	MD179056	OR
4	208000000X	Pediatrics Physician	MD00043484	WA

General Provider Information

NPI Number	:	1528175239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN CHRISTOPHER SHAW MD

Provider Business Mailing Address
First Line	:	500 NE MULTNOMAH ST STE 100
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-2031
Country	:	US
Telephone Number	:	800-813-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1230 7TH AVE
Second Line	:
City	:	LONGVIEW
State	:	WA
Zip	:	98632-3166
Country	:	US
Telephone Number	:	360-636-2400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	05/28/2026

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Directions to “ JOHN CHRISTOPHER SHAW MD” Practice Location

Language	Start Address	Practice Location

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