Provider Demographics
NPI:1598953853
Name:ANDRESS, SHERYL ADRIENNE (MD)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:ADRIENNE
Last Name:ANDRESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7421 SW BRIDGEPORT RD STE 220
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7707
Mailing Address - Country:US
Mailing Address - Phone:503-449-8964
Mailing Address - Fax:
Practice Address - Street 1:7421 SW BRIDGEPORT RD STE 220
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-7707
Practice Address - Country:US
Practice Address - Phone:503-449-8964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27856207Q00000X
CAAO63505207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG91279Medicare UPIN