Alex Renee Shaffer, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1011 Commercial St NE
Salem, OR 97301-1049

Phone

(503) 983-9900

Fax

(503) 983-9899

NPI assigned

Aug 28, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: ashaffer656279@direct.ochin.org

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.

• Benton County

  • Federally Qualified Health Center (FQHC)
  • Corvallis, OR
  • NPI 1275752420
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1740761519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 COMMERCIAL ST NE STE 110",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011036",
            "telephone_number": "503-983-9900",
            "fax_number": "503-983-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 COMMERCIAL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011049",
            "telephone_number": "503-983-9900",
            "fax_number": "503-983-9899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NW 27th St",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973305223",
            "country_code": "US",
            "telephone_number": "541-766-6835",
            "fax_number": "541-766-6186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "ALEX",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-28",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA196705",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500777629",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dan G Sewell, MD
• Brian Sexton
• Brianna Nicole Sexton, MD
• Shade Tree Counseling
• Aidan James Shaffer
• Hannah Shaffer
• Kulsoom K Shah, L.AC.
• Michael Shahbazyan, RPH
• Rebecca Elizabeth Shala, LMHC, LPC
• Nikolay Shalashov

• Physician Assistant in Salem, OR
• Providers in Salem, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.