Individual
JONATHAN GLAZER SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5530 NE 42ND AVE, PORTLAND, OR 97218-1408
(503) 988-5558
Mailing address
5530 NE 42ND AVE, PORTLAND, OR 97218-1408
(503) 988-5558
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A115912
CA
Other
Enumeration date
07/14/2007
Last updated
04/13/2026
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