Provider Demographics
NPI:1992323711
Name:COX, SHELLEY ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:ELIZABETH
Last Name:COX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11862 SW OSLO ST
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-7253
Mailing Address - Country:US
Mailing Address - Phone:541-990-0246
Mailing Address - Fax:
Practice Address - Street 1:16865 BOONES FERRY RD STE 101
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-5281
Practice Address - Country:US
Practice Address - Phone:503-699-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201906303163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery