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

Shannon Marie Stoll, PAC

Individual provider Physician Assistant · NPI 1144896879

Shannon Marie Stoll, PAC is a Physician Assistant in Portland, Oregon. Qualified in 2021, 5 years ago. Practices with The Oregon Clinic, PC, a 352-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
5
Licensed in
OR
In the registry since
2021
Specialties on file
2
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

4805 NE Glisan St # 6N60
Portland, OR 97213-2933
Phone: (503) 281-0561
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA206024 (OR)
Physician Assistant Taxonomy 363A00000X · Licence PA206024 (OR)

Record details

NPI number1144896879
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorYes
NPI enumeratedJune 2, 2021
Last updated in NPPESApril 21, 2026
Certification dateApril 21, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice The Oregon Clinic, Pc — 352 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

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