Organization
PIONEER FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN A EWBANK M.D. (PRESIDENT)
(503) 266-9000
Entity
Organization
Contact information
Practice address
452 NW 1ST AVE, CANBY, OR 97013-3532
(503) 266-9000
(503) 266-9200
Mailing address
452 NW 1ST AVE, CANBY, OR 97013-3532
(503) 266-9000
(503) 266-9200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD21648
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133934
—
OR
Enumeration date
04/02/2008
Last updated
06/18/2008
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