DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: SHANTANA MYLEKA RAE BENALLY RN

MEDICARE: SHANTANA MYLEKA RAE BENALLY RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse9871186ID
2163W00000XRegistered Nurse10055531OR

General Provider Information

NPI Number : 1316897739
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANTANA MYLEKA RAE BENALLY RN
Provider Business Mailing Address
First Line : 211 SE CARUTHERS ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-4502
Country : US
Telephone Number : 971-217-9008
Fax Number : 971-260-0355
Provider Business Practice Location Address
First Line : 703 NE HANCOCK ST
Second Line :
City : PORTLAND
State : OR
Zip : 97212-3955
Country : US
Telephone Number : 971-217-9008
Fax Number : 971-260-0355
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

Similar Medicare Providers

1396734364 — NATIVE AMERICAN REHABILITATION ASSOC INC
Practice Location Address:
703 NE HANCOCK ST
PORTLAND, OR
97212-3955
Practice Phone: 503-230-9875
Practice Fax: 503-331-3441
1013907708 — RUTH ANNE MCGOVERN NP
Practice Location Address:
703 NE HANCOCK ST
PORTLAND, OR
97212-3955
Practice Phone: 503-230-9875
Practice Fax: 503-331-3441
1659362119 — ALISON J GOERL RD
Practice Location Address:
703 NE HANCOCK ST
PORTLAND, OR
97212-3955
Practice Phone: 503-230-9875
Practice Fax: 503-331-3441
1962480509 — DR. LAUREN MARY TITCHENER MD
Practice Location Address:
703 NE HANCOCK ST
PORTLAND, OR
97212-3955
Practice Phone: 503-230-9875
Practice Fax: 503-331-3441
1346213584 — JOHN MICHAEL CHAPMAN LPC
Practice Location Address:
703 NE HANCOCK ST
PORTLAND, OR
97212-3955
Practice Phone: 503-230-9875
Practice Fax: 503-331-3441
1629024021 — ISD RENAL INC
Practice Location Address:
703 NE HANCOCK ST
PORTLAND, OR
97212-3955
Practice Phone: 503-493-3322
Practice Fax: 503-287-9434

Directions to “ SHANTANA MYLEKA RAE BENALLY RN” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.