Provider Demographics
NPI:1811025273
Name:SHELDON, WENDY L (FNP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:L
Last Name:SHELDON
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 1:8725 SW CORTEZ CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7285
Mailing Address - Country:US
Mailing Address - Phone:503-590-2372
Mailing Address - Fax:
Practice Address - Street 1:9370 SW GREENBURG RD STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-5408
Practice Address - Country:US
Practice Address - Phone:503-245-8060
Practice Address - Fax:503-245-8104
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR082010946N1FNP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR082010946N1-FNPOtherSTATE LICENSE NUMBER
OR082010946N1-FNPOtherSTATE LICENSE NUMBER
ORMS0672154OtherDEA NUMBER