Shannon Ann Nelson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

60033952 Issued in WA

Practice address

8507 NE 8TH Way
Vancouver, WA 98664-1980

Phone

(360) 254-5335

Fax

(360) 892-2086

NPI assigned

Jun 12, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1093245169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17705 SE 16TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831918",
            "telephone_number": "360-513-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 NE 8TH WAY",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641980",
            "telephone_number": "360-254-5335",
            "fax_number": "360-892-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SHANNON",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "60033952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard A Nelson, MD
• Joshua Herbert Nelson, M.D.
• Lyle Wilfred Nelson, M.D.,D.M.D.
• Michael John Nelson, M.D.
• Samantha Ashley Nelson
• Siera Krstine Nelson
• Stephen Brooks Nelson, MSW
• Travis L. Nelson
• Wendy Mercedes Nelson
• Zoa Ann Nelson, LMHC

• Physical Therapy Assistant in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.