Individual
KATHY TRAN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3896 BEVERLY AVE NE, BLDG J, SUITE 40, SALEM, OR 97305-1374
(503) 588-0076
(503) 588-0531
Mailing address
PO BOX 190, TOPPENISH, WA 98948-0190
(509) 865-2395
(509) 865-0757
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036131795
IL
207Q00000X
Family Medicine Physician
125-058841
IL
207Q00000X
Family Medicine Physician
A125476
CA
207Q00000X
Family Medicine Physician
Primary
MD169036
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500677323
—
OR
Enumeration date
04/15/2010
Last updated
10/29/2014
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