Shenette Gamoyao Cross
Individual provider Active NPI Massage Therapist · Liberty Lake, WA
NPI 1245871508 · NPPES record last updated Oct 9, 2019
Key facts
- NPI
- 1245871508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA60663658 (WA)
- Practice address
- 2207 N Molter Rd
Liberty Lake, WA 99019-7570 - Phone
- (509) 893-9939
- Fax
- (509) 893-9107
- NPI assigned
- Oct 7, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60663658 | WA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60663658 | WA | Yes |
Addresses
Primary practice location
2207 N Molter Rd
Liberty Lake, WA 99019-7570
Mailing address
6004 Mud Flat Rd
Lacrosse, WA 99143-9656
Phone (509) 980-1098
Other practice location 1
6004 Mud Flat Rd
LaCrosse, WA 99143-9656
Phone (509) 980-1098
Other providers in Liberty Lake, WA
- Heidi Jo Cooper
- Brittany Claire Correll
- Candace Courtney
- Abby Mae Covillo
- Ashley Nicole Creedy
- Clifford Reed Cullings
- Phillip Wayne Curtis
- Jeannie Dalton
- Jennifer Danley
- Michelle Darnell
All providers in Liberty Lake, WA · Massage Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.