Shereck, Evan

Shereck, Evan is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd, Mail Code Cdrc-P, Portland OR 97214. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology. Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology is her primary health care specialty. Shereck, Evan can be contacted via phone (503) 494-0829.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd, Mail Code Cdrc-P Portland OR 97214
Phone: (503) 494-0829
Fax: (503) 494-0714
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD152990 Oregon
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X MD152990 Oregon

Profile Details

NPI number 1184742140
LBN Legal business name Shereck, Evan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2007
Last updated Sep 10th, 2012 - about 13 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 1184742140 NPPES
Oregon MEDICAID 500628915

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