Individual provider

Shannon Goddard, PA

Medical Physician Assistant Physician Assistant Medicare enrolled

Shannon Goddard, PA is a Medical Physician Assistant in Portland, OR, registered under NPI 1780961417. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 3181 SW SAM JACKSON PARK RD # OP31, Portland, OR 97239. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

3181 SW SAM JACKSON PARK RD # OP31, Portland, OR 97239 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
56072 CA Medical Physician Assistant primary
3347 CO Physician Assistant

Licences are recorded in 2 states: CA, CO. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Physician Assistant
PAC ID
2365672896

Enrolled in Medicare 4 times, across 4 states:

StateEnrollment IDProvider type
New Mexico I20170327001171 Practitioner - Physician Assistant
Guam I20190124003835 Practitioner - Physician Assistant
Oregon I20220630002489 Practitioner - Physician Assistant
Washington I20240830001403 Practitioner - Physician Assistant

Medicare enrolment is recorded as approved under the provider type Practitioner - Physician Assistant. There are 4 separate enrolment records across 4 states (NM, GU, OR, WA). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: California and Colorado. Multi-state licensure often means the provider works near a state border, covers more than one office, or delivers care by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

CA California
Licence
56072
Specialty
Medical Physician Assistant
Verify with the CA board →
CO Colorado
Licence
3347
Specialty
Physician Assistant
Verify with the CO board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Medical covers

Definition to come... NUCC Health Care Provider Taxonomy, code 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Medical

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
363AM0700X Medical Physician Assistant Medical 56072 CA primary
363A00000X Physician Assistant 3347 CO

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1780961417 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateNov 9, 2011
Last updatedJan 5, 2026
StatusActive
Sole proprietorNo
CredentialPA
Practice address 3181 SW SAM JACKSON PARK RD # OP31
Portland, OR 97239
(503) 494-6400
This record was updated on Jan 5, 2026, which is recent enough that the contact details are likely still accurate.

Number check

1780961417 passes the NPI check digit test The final digit 7 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 7 8 0 9 6 1 4 1
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 7 7 0 9 6 2 4 2

Sum = 63 · next multiple of 10 = 70 · check digit = 7 · actual last digit = 7

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1780961417?
NPI 1780961417 is the National Provider Identifier assigned to Shannon Goddard, PA in Portland, OR. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Medical cover?
Definition to come...
How do I contact Shannon Goddard, PA?
The phone number on file with NPPES is (503) 494-6400, last updated Jan 5, 2026. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Shannon Goddard, PA accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1780961417 a valid number?
Yes. 1780961417 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.