MEDICARE: MICHAEL DANIEL SHERWOOD

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	163W00000X	Registered Nurse	201040674RN	OR

General Provider Information

NPI Number	:	1841155587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DANIEL SHERWOOD

Provider Business Mailing Address
First Line	:	632 S 72ND ST
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97478-7426
Country	:	US
Telephone Number	:	503-310-1696
Fax Number	:

Provider Business Practice Location Address
First Line	:	632 S 72ND ST
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97478-7426
Country	:	US
Telephone Number	:	503-310-1696
Fax Number	:

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

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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