Individual
SHONDELL DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3705 SE CESAR CHAVEZ BLVD, PORTLAND, OR 97202-1704
(206) 785-1015
(206) 785-1023
Mailing address
3705 SE CESAR CHAVEZ BLVD, PORTLAND, OR 97202-1704
(541) 500-8655
(800) 433-1396
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
PA164846
OR
2084P0800X
Psychiatry Physician
Primary
PA164846
OR
363A00000X
Physician Assistant
PA164846
OR
363AM0700X
Medical Physician Assistant
PA164846
OR
Other
Enumeration date
09/03/2013
Last updated
02/16/2026
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