Individual
SHELDA HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5311 N VANCOUVER AVE, PORTLAND, OR 97217-2731
(503) 281-0308
(503) 281-4691
Mailing address
6606 NE MALLORY AVE, PORTLAND, OR 97211-2424
(503) 803-4547
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200450058NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027742
—
OR
05
—
241378
—
OR
Enumeration date
10/25/2005
Last updated
08/09/2011
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