Individual
CONSTANCE F SHADWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 285-9321
Mailing address
3901 SW HAMILTON ST, PORTLAND, OR 97221-3605
(503) 525-0353
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
WA MD00036788
WA
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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