Shanelle Deann O'Dell in Gresham - Physician Assistant
Shanelle Deann O'Dell - NPI 1679792816
Shanelle Deann O'Dell is a Physician Assistant in Gresham, Oregon. Shanelle Deann O'Dell practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Shanelle Deann O'Dell is 1679792816. The last update date is 2021-06-21.
Shanelle Deann O'Dell's current location address is 440 Nw Division St, Gresham, Oregon. You can contact this provider via phone number 5032159500. The mailing address for Shanelle Deann O'Dell is 440 Nw Division St, Gresham, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shanelle Deann O'Dell |
|---|---|
| Address | 440 Nw Division St, Gresham, Oregon |
| Phone Number | 5032159500 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1679792816 |
|---|---|
| Provider Enumeration Date | 2007-04-25 |
| Last Updated Date | 2021-06-21 |
Provider Mailing Address Detail
| Address | 440 Nw Division St |
|---|---|
| City | Gresham |
| State | Oregon (OR) |
| Post Code | 970305506 |
| Phone Number | 5032159500 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA01195 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 500641047 | OR | -- |
Post Comment/ Review Below
What is the Shanelle Deann O'Dell's unique identification number?
The Shanelle Deann O'Dell has been assigned the NPI (National Provider Identifier) Number 1679792816 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Shanelle Deann O'Dell is physically located?
The Shanelle Deann O'Dell is situated at the following address: 440 Nw Division St, Gresham, OR 970305506.
What is Shanelle Deann O'Dell's specialized field of practice, and what is the corresponding taxonomy classification code?
The Shanelle Deann O'Dell's area of specialization is Physician Assistant, and the corresponding taxonomy code that categorizes this field of practice is 363A00000X.
On what date was the 1679792816 assigned to Shanelle Deann O'Dell?
The Shanelle Deann O'Dell was issued its 1679792816 on 2007-04-25, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Shanelle Deann O'Dell most recently updated or revised?
The details related to Shanelle Deann O'Dell, including its address, specialty, and other relevant information, were last updated or revised on 2021-06-21.