O'Dell, Shanelle Deann

O'Dell, Shanelle Deann is an sole proprietor health care provider with primary practice located at 440 Nw Division St , Gresham OR 97030-5506. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. O'Dell, Shanelle Deann can be contacted via phone (503) 215-9500.

Contact Information

Primary practice address
440 Nw Division St Gresham OR 97030-5506
Phone: (503) 215-9500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA01195 Oregon

Profile Details

NPI number 1679792816
LBN Legal business name O'Dell, Shanelle Deann
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2007
Last updated Jun 21st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679792816 NPPES
Oregon MEDICAID 500641047

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