Individual
SHANE R HANZLIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1508 DIVISION ST SUITE 105, OREGON CITY, OR 97045-1584
(503) 905-4104
(503) 656-9464
Mailing address
1508 DIVISION ST SUITE 105, OREGON CITY, OR 97045-1584
(503) 905-4104
(503) 656-9464
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD170616
OR
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD170616
OR
Other
Enumeration date
06/30/2008
Last updated
05/17/2021
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