Individual
BRETT C. SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, GENERAL SURGERY-L223A, PORTLAND, OR 97239-3011
(503) 494-6900
(503) 494-8884
Mailing address
3181 SW SAM JACKSON PARK RD, GENERAL SURGERY-L223A, PORTLAND, OR 97239-3011
(503) 494-6900
(503) 494-8884
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD14486
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032826
—
OR
Enumeration date
08/03/2006
Last updated
07/16/2007
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