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1902869639

NPI Code Detail

MEDICARE: DR. SHELLIE CRAIG JOSEPHS MD

MEDICARE: DR. SHELLIE CRAIG JOSEPHS MD

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	2085R0204X	Vascular & Interventional Radiology Physician	MD226278	OR
2	2085R0204X	Vascular & Interventional Radiology Physician	J4245	TX
3	2085R0204X	Vascular & Interventional Radiology Physician	C155476	CA
4	2085P0229X	Pediatric Radiology Physician	MD226278	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902869639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELLIE CRAIG JOSEPHS MD

Provider Business Mailing Address
First Line	:	3181 SW SAM JACKSON PARK RD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-3011
Country	:	US
Telephone Number	:	503-494-7660
Fax Number	:

Provider Business Practice Location Address
First Line	:	3181 SW SAM JACKSON PARK RD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-3011
Country	:	US
Telephone Number	:	503-494-7660
Fax Number	:

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	12/09/2025

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Directions to “ DR. SHELLIE CRAIG JOSEPHS MD” Practice Location

Language	Start Address	Practice Location

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