Individual
DR. LIAN R SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1003 PROVIDENCE DR, SUITE 325, NEWBERG, OR 97132-7521
(503) 216-2188
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD0043124
WA
207RC0000X
Cardiovascular Disease Physician
MD159774
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8390684
—
WA
Enumeration date
05/05/2006
Last updated
10/06/2020
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