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General NPI Number Information
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NPI Number | 1518099241
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Entity Type | Individual
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Provider Name | ERIN R SHAWN ANP
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 12710 SE DIVISION ST
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City | PORTLAND
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State | OR
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Zip | 97236-3134
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Country | US
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Telephone | 503-988-3601
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Fax | 503-988-3142
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Provider Business Mailing Address
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Address Line | 421 SW OAK ST 210
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City | PORTLAND
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State | OR
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Zip | 97204-1817
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Country | US
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Telephone | 503-988-3663
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Fax | 503-988-4098
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 20065011NP
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License Number State | OR
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