Shay Forest Witten

Primary specialty

SpecialistTaxonomy code 174400000X

License

BAP-E10249501 Issued in OR

Practice address

2222 NW Lovejoy St Ste 606
Portland, OR 97210-5104

Phone

(503) 413-5915

NPI assigned

Oct 30, 2024

Last updated

Dec 15, 2024By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Wildwood Electrolysis LLC

  • Specialist
  • Portland, OR
  • NPI 1639989205
  NPD Authorized official

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734220800000",
    "number": "1912729898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8803 N TYNDALL AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177029",
            "telephone_number": "541-805-9282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST STE 606",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105104",
            "telephone_number": "503-413-5915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 SE Main St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972143410",
            "country_code": "US",
            "telephone_number": "541-805-9282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTEN",
        "first_name": "SHAY",
        "middle_name": "FOREST",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-12-15",
        "certification_date": "2024-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "BAP-E10249501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Theresa Witt
• Caitlyn Nicole Witte, BSCN
• Richard Allen Witte, R.N.
• Melaura Wittemyer, MD
• James C Witten, MD
• Lea Witter
• Dena Witthaus, D.O.
• Anton Wittinger, LAC., LMT
• Beverly L Wittkopp, MD
• Elisabeth J Wittorff, LCSW

• Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.