Individual ProviderDonald Andrew ShawSocial WorkerBehavioral Health & Social Service ProvidersPractice Address15100 SW Koll Pkwy, Suite A, Beaverton, OR 97006-6026(503) 290-6477PECOS EnrollmentBased on the most recent information from CMS, provider Donald Andrew Shaw does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1780696005Provider TypeIndividualFull NameShaw, Donald AndrewTitleMr.CredentialLCSWGenderMaleSole ProprietorNoEnumeration Date8/13/2006Last Updated9/1/2011Contact InformationPractice LocationPractice Address15100 SW Koll Pkwy, Suite A, Beaverton, OR 97006-6026Phone(503) 290-6477FaxUnlisted FaxMailing LocationMailing Address15100 SW Koll Pkwy, Suite A, Beaverton, OR 97006-6026Phone(503) 290-6477FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseL4086OregonProvider IdentifiersIDDescriptionIssuerID357602DescriptionOtherIssuerMHNMarylandID7734703DescriptionOtherIssuerAETNAMarylandID407367300DescriptionMedicaidIssuerUnlistedMarylandIDA2840146DescriptionOtherIssuerBCBS OF DCDistrict of ColumbiaID64529901DescriptionOtherIssuerBCBS OF MDMarylandID796986000DescriptionOtherIssuerMAGELLANMarylandID254442DescriptionOtherIssuerKAISERMaryland