Active NPI
Ellen Shaw, PT
- Physical Therapist
- Spokane Valley, WA
National Provider Identifier
1053720482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 60462884
- Practice address
- 1005 N Evergreen Rd Ste 10
Spokane Valley, WA 99216-1485 - Phone
- (509) 926-5367
- Fax
- (509) 928-5508
- NPI assigned
- Aug 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 60462884 | WA | Primary |
Addresses
Primary practice location
1005 N Evergreen Rd Ste 10
Spokane Valley, WA 99216-1485
Mailing address
16083 SW Upper Boones Ferry Rd Ste 300
Tigard, OR 97224-7736
Phone (800) 219-8835
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01383825 | Other | WA | RR MEDICARE PTAN |
| 2038544 | Medicaid | WA | |
| 0329441 | Other | WA | WA L&I |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60462884 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Bothell, WA
- NPI 1114376563
-
- Physical Therapist
- Portland, OR
- NPI 1700862000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419984000000",
"number": "1053720482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
"city": "TIGARD",
"state": "OR",
"postal_code": "972247736",
"telephone_number": "800-219-8835",
"fax_number": "503-639-9699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 N EVERGREEN RD STE 10",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992161485",
"telephone_number": "509-926-5367",
"fax_number": "509-928-5508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "ELLEN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-11",
"last_updated": "2014-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "60462884",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PTAN",
"identifier": "P01383825",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2038544",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA L&I",
"identifier": "0329441",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.