Look up the most recent NPI and PECOS records

Shannon Fay

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

PECOS Enrollment

Based on the most recent information from CMS, provider Shannon Fay is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1023177565
Provider Type
Individual
Full Name
Fay, Shannon
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
12/8/2006
Last Updated
12/29/2020

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-3442

(503) 494-5330

Mailing Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-3442

(503) 494-5330

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA01170 Oregon
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA01170 Oregon

Shannon Fay

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Holmes, Lauren Rebecca

Hartmann, Kerith J

Rozek, Jennifer Christine

Armstrong, Emily

Cox, Ashley J

Makarachi, Teardaad

Eikamp, Mackenzie Jean

Thoms, Trisha A

Hutchins, Abbie Jo

Kelly, Nicole