Provider Demographics
NPI:1669681573
Name:YEN-SHIPLEY, NANCY (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:YEN-SHIPLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:YEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5050 NE HOYT ST STE 626
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2956
Mailing Address - Country:US
Mailing Address - Phone:503-231-1426
Mailing Address - Fax:503-231-0316
Practice Address - Street 1:5050 NE HOYT STREET SUITE 640
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213
Practice Address - Country:US
Practice Address - Phone:503-231-1426
Practice Address - Fax:503-231-0316
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101247345207X00000X
ORMD153910207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500636835Medicaid
OR500636835Medicaid