Active NPI
Mary Alice Shepard, M.D.
- Internal Medicine Physician
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD00023639
- Practice address
- 2211 E Mill Plain Blvd
Vancouver, WA 98661-4329 - Phone
- (360) 418-6001
- Fax
- (130) 418-6008
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | WA MD00023639 | WA | |
| Internal Medicine Physician | 207R00000X | MD00023639 | WA | Primary |
Addresses
Primary practice location
2211 E Mill Plain Blvd
Vancouver, WA 98661-4329
Mailing address
PO Box 31001-4114
Pasadena, CA 91110-0001
Other practice location 1
624 E Front Ave
Spokane, WA 99202-2139
Phone (509) 626-9900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of California, San Francisco School of Medicine, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
624 E Front Ave
Spokane, WA 99202-2139
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00023639 | WA | MD | Internal Medicine Physician |
| WA MD00023639 | WA | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services Washington | Internal Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services Washington | Current | Accepting new patients |
Locations
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
1230 7th Ave
Ofc
Longview, WA 98632
Phone (360) 636-2400
624 E Front Ave
Spokane, WA 99202
Phone (509) 626-9900
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Interoperability endpoints
- mshepard4080360@wm.providencedirect.org
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pulmonary Disease Physician
- Spokane, WA
- NPI 1194099390
Internal Medicine
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Internal Medicine, WA
-
- General Practice Physician
- Spokane, WA
- NPI 1306391446
-
- General Practice Physician
- Portland, OR
- NPI 1871848457
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760313600000",
"number": "1669485165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31001-4114",
"city": "PASADENA",
"state": "CA",
"postal_code": "911100001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 E MILL PLAIN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986614329",
"telephone_number": "360-418-6001",
"fax_number": "130-418-6008"
}
],
"practiceLocations": [
{
"address_1": "624 E Front Ave",
"address_purpose": "LOCATION",
"city": "Spokane",
"state": "WA",
"postal_code": "992022139",
"country_code": "US",
"telephone_number": "509-626-9900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHEPARD",
"first_name": "MARY",
"middle_name": "ALICE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2025-10-13",
"certification_date": "2025-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "WA",
"license": "WA MD00023639",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00023639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.