Shelby Scott Thompson, crm
Peer Specialist in Gresham, OR. Individual provider (NPI-1).
NPI number1104725860
StatusActive
Last updated in NPPESNov 2, 2026
Details
- NPI
- 1104725860
- Entity type
- Individual (NPI-1)
- Name
- Shelby Scott Thompson
- Credential
- crm
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 2, 2026
- Certification date
- Nov 1, 2026
- Last updated
- Nov 2, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | 6839023 | OR | Yes |
Practice location
2072 Ne Burnside RdGresham, OR 97030-7950
Phone 971-436-2560
Mailing address
2072 Ne Burnside RdGresham, OR 97030-7950
Phone 971-436-2560
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 50 Peer Specialist providers in Gresham · All 2,430 providers in Gresham
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