Individual
DR. SHAWN TIMOTHY PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2222 NW LOVEJOY ST, SUITE 606, PORTLAND, OR 97210-3033
(503) 229-7554
(503) 274-5400
Mailing address
1040 NW 22ND AVE, STE 660, PORTLAND, OR 97210-3083
(503) 413-7162
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD22839
OR
207RC0000X
Cardiovascular Disease Physician
Primary
MD22839
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016616
—
WA
05
—
287717
—
OR
Enumeration date
09/06/2005
Last updated
08/16/2018
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