Individual
SHANNON KIMBERLY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9701 SW BARNES RD, SUITE 300, PORTLAND, OR 97225-6772
(503) 297-8018
(503) 292-6601
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A95971
CA
207RG0100X
Gastroenterology Physician
Primary
MD153467
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A959710
—
CA
05
—
1780888446
—
WA
05
—
500635251
—
OR
Enumeration date
06/14/2007
Last updated
11/19/2024
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