Organization
SD WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHONDELL DIAZ PA-C (PHYSICIAN ASSOCIATE)
(203) 305-9859
Entity
Organization
Contact information
Practice address
3705 SE CESAR E CHAVEZ BLVD, PORTLAND, OR 97202-1704
(503) 483-6394
(503) 483-6395
Mailing address
3705 SE CESAR E CHAVEZ BLVD, PORTLAND, OR 97202-1704
(503) 483-6394
(503) 483-6395
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/11/2024
Last updated
01/16/2026
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