Individual
DR. CASEY SHILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5000 N WILLAMETTE BLVD # 153, PORTLAND, OR 97203-5798
(503) 943-8143
Mailing address
5000 N WILLAMETTE BLVD # 153, PORTLAND, OR 97203-5798
(503) 943-8143
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
200242028
OR
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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