Provider Demographics
NPI:1881444917
Name:PATIL, SHILPA
Entity type:Individual
Prefix:
First Name:SHILPA
Middle Name:
Last Name:PATIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 SW MURRAY SCHOLLS PL
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-9816
Mailing Address - Country:US
Mailing Address - Phone:503-494-3151
Mailing Address - Fax:
Practice Address - Street 1:11200 SW MURRAY SCHOLLS PL
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-9816
Practice Address - Country:US
Practice Address - Phone:503-494-3151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR64420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist