Individual
SHEA MERTENS DEKLOTZ
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) 494-4314
(503) 346-6810
Mailing address
1400 SW 5TH AVE STE 500, PORTLAND, OR 97201-5537
(503) 346-8015
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA159893
OR
363AS0400X
Surgical Physician Assistant
Primary
PA159893
OR
Other
Enumeration date
12/28/2012
Last updated
11/12/2025
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