Individual provider · Type 1 NPI

Jessica Elaine Shelnutt

Periodontics · Clackamas, OR

NPI number 1912557117 Active

Practice location

10209 SE Sunnyside Rd
Clackamas, OR 97015-9782

Mailing address

5025 SE 28th Ave
Portland, OR 97202-4445

Other practice locations

  • 5025 SE 28th Ave, Portland, OR 97202-4445 · (503) 286-6868

Specialties and licenses

TaxonomyCodeLicense
Periodontics Primary 1223P0300X000412 (OR)

Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

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About NPI 1912557117

Jessica Elaine Shelnutt's National Provider Identifier is 1912557117, issued on Sep 19, 2019. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Clackamas, OR. The record was last updated on Sep 19, 2019.