Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shannon E Jackson, MD

Individual provider Internal Medicine Physician · NPI 1558301168

Shannon E Jackson, MD is an Internal Medicine in Portland, Oregon. Graduated from Loma Linda University School of Medicine in 2003, 23 years ago. Practices with Providence Health and Services - Washington, a 264-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
23
Trained at
Loma Linda University School of Medicine
Licensed in
OR
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4805 NE Glisan St
Portland, OR 97213-2933
Phone: (503) 215-2393
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD25874 (OR)

Record details

NPI number1558301168
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 8, 2006
Last updated in NPPESMarch 18, 2021
Certification dateMarch 18, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 2003 (23 years in practice)
Group practice Providence Health And Services - Washington — 264 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations8 on file with Medicare

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