Shirelle Latrice Clark, NP - Medicare Nurse Practitioner in Portland, OR

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Shirelle Latrice Clark, NP is a medicare enrolled "Nurse Practitioner - Family" in Portland, Oregon. She graduated from nursing school in 2016 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Mid-columbia Medical Center, Tuality Medical Group Llc and her current practice location is 3303 S Bond Ave, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 494-6594.

Shirelle Latrice Clark is licensed to practice in Oregon (license number 10003750) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1144797085.

Contact Information

Shirelle Latrice Clark, NP
3303 S Bond Ave,
Portland, OR 97239-4501
(503) 494-6594
(503) 494-5385

Map and Direction




Provider's Profile

Full NameShirelle Latrice Clark
GenderFemale
SpecialityNurse Practitioner
Experience9 Years
Location3303 S Bond Ave, Portland, Oregon
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Shirelle Latrice Clark graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1144797085
  • Provider Enumeration Date: 10/29/2018
  • Last Update Date: 03/21/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2769728005
  • Enrollment ID: I20230405001328

Medical Identifiers

Medical identifiers for Shirelle Latrice Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1144797085NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 10003750 (Oregon)Primary
363LF0000XNurse Practitioner - Family RN228546 (Georgia)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Mid-columbia Medical CenterThe dalles, ORHospital
Tuality Community HospitalHillsboro, ORHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Mid-columbia Medical Center377948725198
Tuality Medical Group Llc7416173414239

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shirelle Latrice Clark allows following entities to bill medicare on her behalf.
Entity NameMid-columbia Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053409599
PECOS PAC ID: 3779487251
Enrollment ID: O20031209000244
Entity NameUniversity Professional Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376709535
PECOS PAC ID: 4880760107
Enrollment ID: O20080910000013
Entity NameTuality Medical Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073929782
PECOS PAC ID: 7416173414
Enrollment ID: O20140729000238

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shirelle Latrice Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Shirelle Latrice Clark, NP
1400 Sw 5th Ave Ste 500,
Portland, OR 97201-5537

Ph: (866) 617-6855		Shirelle Latrice Clark, NP
3303 S Bond Ave,
Portland, OR 97239-4501

Ph: (503) 494-6594

Reviews and Comments


Nurse Practitioner Nurses in Portland, OR

Mrs. Anjalee Nix Rowe, NP
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Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239
Phone: 503-494-3988    
Ms. Susan Irene Smith, RN, FNP
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Practice Location: 5100 Sw Macadam Ave, Suite 200, Portland, OR 97239
Phone: 971-202-5500    Fax: 971-202-5555
Iva Juric,
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Practice Location: 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239
Phone: 503-494-4808    
Ms. Jessica A Dudley, FNP
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Practice Location: 3550 N Interstate Ave, Portland, OR 97227
Phone: 503-746-1575    
Summer Morgan Massina, ARNP
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Practice Location: 721 Nw 9th Ave Ste 100, Portland, OR 97209
Phone: 503-525-0090    
Dr. Jeffery Wise, PMHNP-BC
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Medicare: Medicare Enrolled
Practice Location: 1834 Nw 25th Ave Apt 504, Portland, OR 97210
Phone: 971-354-9242    
A'lissa Richards, PMHNP
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Medicare: Medicare Enrolled
Practice Location: 12121 E Burnside St, Portland, OR 97216
Phone: 971-361-7700    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.