Individual
PATRICK SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.074856
IL
207R00000X
Internal Medicine Physician
Primary
MD209997
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD209997
MEDICAL LICENSE
OR
Enumeration date
11/16/2015
Last updated
08/03/2022
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