Provider Demographics
NPI:1437325669
Name:SHANGRAW, PATRICIA F (FAMILY NURSE PRACTIT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:F
Last Name:SHANGRAW
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:MARY
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5776 SW CALUSA LOOP
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062
Mailing Address - Country:US
Mailing Address - Phone:503-692-5850
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:MAIL CODE UHN-65 PAT CLINIC OREGON HEALTH AND SCIENCE U
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3098
Practice Address - Country:US
Practice Address - Phone:503-494-1100
Practice Address - Fax:503-494-1110
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200650158NPFNPPP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily