MIRANDA SHEA BOEH NP NPI 1649574443

NPI Information

NPI: 1649574443
Provider Name: MIRANDA SHEA BOEH, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
17979 NE GLISAN ST
PORTLAND, OR
ZIP 97230
Phone: (503) 962-1791
Get Directions

Miranda Shea Boeh, NP is a family nurse practitioner in Portland, OR with 14 years of experience. Miranda Shea Boeh, NP NPI is 1649574443. 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:

17979 NE GLISAN ST
PORTLAND, OR
ZIP 97230-507
Phone: (503) 962-1791

The NPI 1649574443 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/7/2011 and was last updated on 3/29/2021.

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
1	363LF0000X	Nurse Practitioner	Family	201600700NP-PP	OREGON	Yes
2	363LF0000X	Nurse Practitioner	Family	20366	CALIFORNIA	No

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
1	500707893	MEDICAID	OREGON

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: 4/28/2024

NPI Synchronization or Removal

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