Shaw, Jill Marie
Shaw, Jill Marie is an individual health care provider with primary practice located at 6564 Se Lake Rd Ste 200 , Milwaukie OR 97222-2237. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Gynecology is her primary health care specialty. Shaw, Jill Marie can be contacted via phone (503) 908-5880.Contact Information
Primary practice address
6564 Se Lake Rd Ste 200
Milwaukie OR 97222-2237
Phone: (503) 908-5880
Fax: (888) 475-8729
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | DO25570 | Oregon |
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | DO25570 | Oregon |
Profile Details
| NPI number | 1770576340 |
|---|---|
| LBN Legal business name | Shaw, Jill Marie |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 29th, 2005 |
| Last updated | May 18th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770576340 | NPPES |
| Other | 218071 | MEDICARE PIN | |
| MEDICAID | 213528 | MEDICARE PIN | |
| MEDICAID | 1770576340 | MEDICARE PIN |
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