Healthcare Provider Details

I. General information

NPI: 1124981808
Provider Name (Legal Business Name): SHALOM HEALTH HUB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 SW MASTERS LOOP APT 212
BEAVERTON OR
97078-1453
US

IV. Provider business mailing address

4540 SW MASTERS LOOP APT 212
BEAVERTON OR
97078-1453
US

V. Phone/Fax

Practice location:
  • Phone: 971-507-2209
  • Fax:
Mailing address:
  • Phone: 971-507-2209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SUSAN NJOROGE
Title or Position: CEO
Credential:
Phone: 971-507-2209