| Doctor Name: | MS. AMANDA J. SHIELDS |
| NPI Number: | 1417026410 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP-PP |
| License Number: | 200850093NP |
| Business Practice Address: | 693 Glatt Cir Woodburn, OR - 970719600 |
| Business Phone Number: | 5039820403 |
| Business Fax Number: | 5039885112 |
| Mailing Address: | 4531 Se Belmont St Ste 250, PORTLAND |
| State: | OR |
| Postal Code: | 972151675 |
| Phone Number: | 5039885303 |
| Fax Number: | 5039885112 |
| NPI Enumeration Date: | 11/06/2006 |
| NPI Last Update Date: | 11/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 200850093NP |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |