IndividualActive
Shelly Wimmer, PA-C
NPI 1083092514 · Medical Physician Assistant · Independence, OR
Provider details
- NPI number
- 1083092514
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA 1779965 (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1430 Monmouth St
Independence, OR 97351-1127
Phone: (503) 838-1133
Fax: (503) 838-5138
Approximate (ZIP-level) locationGet directions
Mailing address
1430 Monmouth St
Independence, OR 97351-1127
Registry dates
- Enumerated
- 2015-05-17
- Last updated
- 2017-03-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.