Healthcare Provider Details

I. General information

NPI: 1396873105
Provider Name (Legal Business Name): MORGEN L. SHAFF PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12230 LIONESS WAY
PARKER CO
80134-5603
US

IV. Provider business mailing address

PO BOX 7410886
CHICAGO IL
60674-0884
US

V. Phone/Fax

Practice location:
  • Phone: 303-282-7772
  • Fax: 702-977-1496
Mailing address:
  • Phone: 702-899-0595
  • Fax: 702-977-1496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA.0003201
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: