MEDICARE: MRS. WENDY L. SHELDON FNP

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
1	363LF0000X	Family Nurse Practitioner	082010946N1FNP	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	082010946N1-FNP	OTHER	OR	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1811025273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. WENDY L. SHELDON FNP

Provider Business Mailing Address
First Line	:	8725 SW CORTEZ CT
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97008-7285
Country	:	US
Telephone Number	:	503-590-2372
Fax Number	:

Provider Business Practice Location Address
First Line	:	9370 SW GREENBURG RD STE A
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97223-5408
Country	:	US
Telephone Number	:	503-245-8060
Fax Number	:	503-245-8104

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	03/07/2023

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