Individual
SHELBY SUBRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-5058
(503) 494-3465
Mailing address
1400 SW 5TH AVE, PORTLAND, OR 97201-5537
(866) 617-6855
(503) 346-8015
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA.0006160
CO
363AM0700X
Medical Physician Assistant
Primary
PA216320
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500824302
—
OR
Enumeration date
06/26/2019
Last updated
11/12/2025
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