Individual provider · Type 1 NPI

Shannon Marie Stoll, PAC

Surgical Physician Assistant · Portland, OR

NPI number 1144896879 Active

Practice location

4805 NE Glisan St # 6N60
Portland, OR 97213-2933

Call (503) 281-0561 Map

Mailing address

541 NE 20th Ave Ste 225
Portland, OR 97232-2895

Other practice locations

  • 11000 SW Stratus St Ste 205, Beaverton, OR 97008-7104 · (503) 281-0561

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA206024 (OR)
Surgical Physician Assistant Primary 363AS0400XPA206024 (OR)

Surgical Physician Assistant: Definition to come...

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About NPI 1144896879

Shannon Marie Stoll, PAC's National Provider Identifier is 1144896879, issued on Jun 2, 2021. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Portland, OR. The record was last updated on Apr 21, 2026.