Individual
SHAYNE MAHEALANI AHWAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
15700 SW GREYSTONE CT, BEAVERTON, OR 97006-6011
(971) 262-9150
(971) 262-9151
Mailing address
15700 SW GREYSTONE CT, BEAVERTON, OR 97006-6011
(971) 262-9150
(971) 262-9151
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA187846
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2099260
—
WA
05
—
500742931
—
OR
Enumeration date
04/24/2018
Last updated
05/11/2021
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