Provider Demographics
NPI:1477431385
Name:NANCY YEN SHIPLEY MD LLC
Entity type:Organization
Organization Name:NANCY YEN SHIPLEY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:YEN SHIPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:971-971-4325
Mailing Address - Street 1:9555 SW BARNES RD STE 275
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6680
Mailing Address - Country:US
Mailing Address - Phone:971-971-4325
Mailing Address - Fax:971-231-0270
Practice Address - Street 1:9555 SW BARNES RD STE 275
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6680
Practice Address - Country:US
Practice Address - Phone:971-971-4325
Practice Address - Fax:971-231-0270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty