JILL MARIE SHAW D.O. NPI 1770576340

NPI Information

NPI: 1770576340
Provider Name: JILL MARIE SHAW, D.O.
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Individual

Specialization: Gynecology

PECOS Registration: Yes

Address:
6564 SE LAKE RD STE 200
MILWAUKIE, OR
ZIP 97222
Phone: (503) 908-5880
Get Directions

Jill Marie Shaw, D.O. is a gynecology obstetrics gynecology in Milwaukie, OR with 24 years of experience. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee Jill Marie Shaw, D.O. NPI is 1770576340. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: OHIO UNIVERSITY, COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:2000

The provider's business location address is:

6564 SE LAKE RD STE 200
MILWAUKIE, OR
ZIP 97222-237
Phone: (503) 908-5880
Fax: (888) 475-8729

The NPI 1770576340 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 8/29/2005 and was last updated on 5/18/2020.

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	207V00000X	Obstetrics & Gynecology		DO25570	OREGON	No
2	207VG0400X	Obstetrics & Gynecology	Gynecology	DO25570	OREGON	Yes

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	213528	MEDICAID	OREGON
2	218071	OTHER		MEDICARE PIN
3	1770576340	MEDICAID	WASHINGTON

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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