Healthcare Provider Details

I. General information

NPI: 1407147283
Provider Name (Legal Business Name): CANDICE RAY SHELDON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2011
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

IV. Provider business mailing address

3181 SW SAM JACKSON PARK RD OREGON HEALTH & SCIENCE UNIVERSITY MAIL CODE BICC
PORTLAND OR
97239
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-4502
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD224382
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberMD224382
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: