Individual
MS. SHAUNA L ENSMINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4920 N. INTERSTATE AVENUE, PORTLAND, OR 97217-3653
(503) 215-3300
(503) 215-3350
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD00041452
WA
207Q00000X
Family Medicine Physician
Primary
MD19637
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080234
—
OR
05
—
8398182
—
WA
Enumeration date
08/31/2005
Last updated
03/09/2021
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