Individual provider Active NPI

Shana R Green, PMHNP-BC/ ANP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1861761207
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201150173NP Issued in OR
Practice address
3930 SE Division St
Portland, OR 97202-1643
Phone
(503) 418-3900
NPI assigned
Dec 14, 2011
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201150173NP OR Primary

Addresses

Primary practice location

3930 SE Division St
Portland, OR 97202-1643

Mailing address

1400 SW 5TH Ave
Portland, OR 97201-5537
Phone (503) 418-3900

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120215000267 OR Practitioner - Nurse Practitioner 6709044159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, San Francisco School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Health and Science UniversityGroup PAC ID 1759328842, shared by 6 NPIs, 93 clinicians

Practice addresses (Care Compare)

3930 SE Division St
Portland, OR 97202-1643
Phone (503) 418-3900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
APN.0993439-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Health & Science University CurrentSince May 1, 2025 Accepting new patients
Oregon Health & Science University Current Accepting new patients
Oregon Health & Science University CurrentSince May 1, 2025 Accepting new patients
University Professional Services Past Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

3930 SE Division St
Portland, OR 97202
Phone (503) 418-3900

Interoperability endpoints

  • Direct secure messaging: sgreen195827@direct.ohsu.edu
  • Direct secure messaging: shana.green.p1@direct.voaor.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1861761207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SW 5TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015537",
            "telephone_number": "503-418-3900",
            "fax_number": "503-418-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021643",
            "telephone_number": "503-418-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SHANA",
        "middle_name": "R",
        "credential": "PMHNP-BC/ ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-14",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201150173NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.