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Individual

DR. SAMUEL GARDNER SHILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2701 NW VAUGHN ST STE 150, PORTLAND, OR 97210-5379
(503) 229-8455
(503) 229-7028
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
207Y00000X
Otolaryngology Physician
Primary
MD25260
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2059958
WA
05
269657
OR
Enumeration date
06/28/2006
Last updated
06/20/2025
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