Provider Demographics
NPI:1164899498
Name:KUEHL, SHAWN NICOLLE (FNP)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:NICOLLE
Last Name:KUEHL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3403 SE YELLOWBIRD AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-5383
Mailing Address - Country:US
Mailing Address - Phone:206-235-2286
Mailing Address - Fax:
Practice Address - Street 1:1011 3RD ST
Practice Address - Street 2:
Practice Address - City:TILLAMOOK
Practice Address - State:OR
Practice Address - Zip Code:97141-8292
Practice Address - Country:US
Practice Address - Phone:503-815-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201506110NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily