MADELINE SHEPHERD NPI 1063001550

NPI Information

  • NPI: 1063001550
  • Provider Name: MADELINE SHEPHERD
  • Classification: Peer Specialist - 175T00000X
  • Entity Type: Individual
  • Address: 1316 SE 12TH AVE
    PORTLAND, OR
    ZIP 97214
  • Phone: (866) 231-3007

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NPI Details

Madeline Shepherd is a peer specialist in Portland, OR. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. Madeline Shepherd NPI is 1063001550. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1316 SE 12TH AVE
PORTLAND, OR
ZIP 97214-604
Phone: (866) 231-3007

The enumeration date for this NPI number is 1/11/2021 and was last updated on 1/11/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1175T00000XPeer Specialist20-CRM-147OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
120-CRM-147OTHEROREGONMHACBO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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