MEDICARE: ASHLEY SHRADER NP

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	AP61475381	WA
2	363LF0000X	Family Nurse Practitioner	77505	ID
3	363LF0000X	Family Nurse Practitioner	RXN.0109473-NP	CO
4	363LF0000X	Family Nurse Practitioner	R264279	MD
5	363LF0000X	Family Nurse Practitioner	0024189137	VA
6	363LF0000X	Family Nurse Practitioner	RN2387569	MA
7	363LF0000X	Family Nurse Practitioner	NP1039999	DC
8	363LF0000X	Family Nurse Practitioner	201905151NP-PP	OR

General Provider Information

NPI Number	:	1982190690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY SHRADER NP

Provider Business Mailing Address
First Line	:	27 CRATER LAKE AVE
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-7444
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1025 CONNECTICUT AVE NW STE 1000
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-5417
Country	:	US
Telephone Number	:	202-946-2388
Fax Number	:

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

Provider Enumeration Date	:	07/05/2018
Last Update Date	:	06/09/2025

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