Shauna L Ensminger, MD
Family Medicine in Portland, OR. Individual provider (NPI-1).
NPI number1619960002
StatusActive
Last updated in NPPESMar 9, 2021
Details
- NPI
- 1619960002
- Entity type
- Individual (NPI-1)
- Name
- Ms. Shauna L Ensminger
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 31, 2005
- Certification date
- Mar 9, 2021
- Last updated
- Mar 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | MD19637 | OR | Yes |
| 207Q00000X | Family Medicine | MD00041452 | WA |
Practice location
4920 N. Interstate AvenuePortland, OR 97217-3653
Phone 503-215-3300 · Fax 503-215-3350
Mailing address
Po Box 3158Portland, OR 97208-3158
Phone 503-215-6494 · Fax 503-215-6644
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