Individual
JOHN STEVEN SHIPLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
2040 NW NEWCASTLE ST, ROSEBURG, OR 97470-1657
(541) 673-1808
(541) 673-2117
Mailing address
16083 SW UPPER BOONES FERRY RD, STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1057
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15837
—
OR
01
—
P00451677
RR MEDICARE
OR
Enumeration date
04/18/2007
Last updated
11/12/2012
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