Shane A Marx
Individual provider Active NPI Attendant Care Provider · Independence, OR
NPI 1477199537 · NPPES record last updated Nov 25, 2019
Key facts
- NPI
- 1477199537
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Attendant Care Provider 3747A0650X
- Practice address
- 6200 Poplar LN
Independence, OR 97351-9659 - Phone
- (503) 999-3833
- NPI assigned
- Nov 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Yes |
Addresses
Primary practice location
6200 Poplar LN
Independence, OR 97351-9659
Mailing address
6200 Poplar LN
Independence, OR 97351-9659
Phone (503) 999-3833
Other providers in Independence, OR
- Kristy Lee Lemmon
- L. Nicole Lewis
- Tyler Charles Lonsford
- Marionberry Speech Therapy, LLC
- Mark Diaz D.C. P.C.
- Susana McAllaster
- David Patrick McDarby
- Mobility Access Options NW, Inc.
- Monica Gabaldon, LCSW, LLC
- Lynne Moore
All providers in Independence, OR · Attendant Care Provider in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.