Individual
SHANNON K SHERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
9427 SW BARNES RD, STE 498, PORTLAND, OR 97225-6652
(503) 216-0900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00873
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286755
—
OR
Enumeration date
06/15/2006
Last updated
06/25/2021
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