Individual provider Active NPI

Elizabeth Shaw Allen, M.D.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1871507491
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17738 Issued in OR
Practice address
3710 SW US Veterans Hospital Rd
Portland VA Medical Center, P3-Med
Portland, OR 97207-1034
Phone
(503) 220-8262
Fax
(503) 721-7807
NPI assigned
Jul 28, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17738 OR Primary

Addresses

Primary practice location

3710 SW US Veterans Hospital Rd
Portland VA Medical Center, P3-Med
Portland, OR 97207-1034

Mailing address

3710 SW US Veterans Hospital Rd
Portland VA Medical Center, P3-Med, P.O. Box 1034
Portland, OR 97239-2964
Phone (503) 220-8262

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110615000334 OR Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4183801301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17738ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1871507491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD",
            "address_2": "PORTLAND VA MEDICAL CENTER, P3-MED, P.O. BOX 1034",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392964",
            "telephone_number": "503-220-8262",
            "fax_number": "503-721-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD",
            "address_2": "PORTLAND VA MEDICAL CENTER, P3-MED",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972071034",
            "telephone_number": "503-220-8262",
            "fax_number": "503-721-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "ELIZABETH",
        "middle_name": "SHAW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "17738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.