Individual
SHANNON M. GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD # OP31, PORTLAND, OR 97239-3011
(503) 494-6400
Mailing address
3181 SW SAM JACKSON PARK RD # OP31, PORTLAND, OR 97239-3011
(503) 494-6400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3347
CO
363AM0700X
Medical Physician Assistant
Primary
56072
CA
Other
Enumeration date
11/09/2011
Last updated
01/05/2026
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