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General NPI Number Information
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NPI Number | 1902869639
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Entity Type | Individual
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Provider Name | SHELLIE CRAIG JOSEPHS MD
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Gender | Female
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 3181 SW SAM JACKSON PARK RD
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City | PORTLAND
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State | OR
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Zip | 97239-3011
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Country | US
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Telephone | 503-494-7660
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Fax |
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Provider Business Mailing Address
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Address Line | 3181 SW SAM JACKSON PARK RD
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City | PORTLAND
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State | OR
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Zip | 97239-3011
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Country | US
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Telephone | 503-494-7660
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Fax |
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | MD226278
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | J4245
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | C155476
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | MD226278
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License Number State | OR
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