Individual
DR. SHELLEY SUZANNE SELPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, DEPARTMENT OF FAMILY MEDICINE, PORTLAND, OR 97239-3011
(503) 528-4264
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE: FM, PORTLAND, OR 97239-3011
(503) 528-4264
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
9145
ND
207Q00000X
Family Medicine Physician
Primary
MD167249
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12160
—
ND
01
—
24779
BLUE CROSS BLUE SHIELD
ND
Enumeration date
03/05/2007
Last updated
04/29/2015
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