Healthcare Provider Details

I. General information

NPI: 1669237160
Provider Name (Legal Business Name): LISA HANSHAW SEHY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16144 SE HAPPY VALLEY TOWN CENTER DR STE 101
HAPPY VALLEY OR
97086-4257
US

IV. Provider business mailing address

2050 LESLIES WAY
WEST LINN OR
97068-4643
US

V. Phone/Fax

Practice location:
  • Phone: 503-353-1272
  • Fax:
Mailing address:
  • Phone: 801-953-5795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10042963
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6914624-4405
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number6914624-3102
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number10042963
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: