Individual
DR. IRVING SHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, MAIL CODE: DC-8S, PORTLAND, OR 97239-3011
(503) 418-5443
(503) 418-1385
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE: DC-8S, PORTLAND, OR 97239-3011
(503) 418-5443
(503) 418-1385
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101240637
VA
208600000X
Surgery Physician
0101240637
VA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD169191
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500676173
—
OR
01
—
R1766591
MEDICARE PTAN
OR
Enumeration date
09/27/2006
Last updated
03/28/2016
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