Individual
TAYLOR SHANE SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
789 WASHINGTON ST W, VALE, OR 97918-1147
(801) 859-2595
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(086) 429-3762
(208) 642-9598
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA218950
OR
363A00000X
Physician Assistant
PA2737
ID
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500833420
—
OR
Enumeration date
05/05/2023
Last updated
01/14/2026
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