Individual
DR. MAISIE L. SHINDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK ROAD PV01, PORTLAND, OR 97239
(503) 494-2544
(503) 494-4631
Mailing address
3181 SW SAM JACKSON PARK ROAD PV01, PORTLAND, OR 97239
(503) 494-2544
(503) 494-4631
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
205752
NY
207Y00000X
Otolaryngology Physician
Primary
MD28632
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01716861
—
NY
01
—
01Z212
EMPIRE BC.BS
NY
05
—
024306
—
OR
01
—
4638790
AETNA
NY
Enumeration date
07/18/2006
Last updated
11/08/2012
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