MEDICARE: DR. AUDREY MAY SHERMAN PH.D.

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	103G00000X	Clinical Neuropsychologist	1490	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639133564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUDREY MAY SHERMAN PH.D.

Provider Business Mailing Address
First Line	:	1916 SW MARIGOLD ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97219-4150
Country	:	US
Telephone Number	:	503-334-7019
Fax Number	:	503-892-4557

Provider Business Practice Location Address
First Line	:	10700 SW BEAVERTON HILLSDALE HWY STE 500
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97005-3037
Country	:	US
Telephone Number	:	503-334-7019
Fax Number	:	503-892-4557

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

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	12/07/2023

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