MEDICARE: SACHIN SHRENIK SHAH DO

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	207Q00000X	Family Medicine Physician	M0264	TX
2	207Q00000X	Family Medicine Physician	DO228295	OR
3	207Q00000X	Family Medicine Physician	OP70068057	WA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780770966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SACHIN SHRENIK SHAH DO

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	:	2850 NW NICOLAI ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97210-2018
Country	:	US
Telephone Number	:	800-813-2000
Fax Number	:

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	01/26/2026

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Directions to “ SACHIN SHRENIK SHAH DO” Practice Location

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