Individual
DR. JAY AJIT SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
29345 SW TOWN CENTER LOOP E STE 110, WILSONVILLE, OR 97070
(503) 582-2100
(503) 582-2101
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD166559
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500673576
—
OR
Enumeration date
05/19/2009
Last updated
10/14/2020
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