Individual provider Active NPI

Amy Hicks, LPN

  • Home Health Registered Nurse
  • Port Townsend, WA
National Provider Identifier
1336086073
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
LP61345795 Issued in WA
Practice address
2500 W Sims Way Ste 300
Port Townsend, WA 98368-2234
Phone
(360) 385-0610
Fax
(360) 379-8259
NPI assigned
Apr 30, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered Nurse 163WH1000X LP61345795 WA
Home Health Registered Nurse 163WH0200X LP61345795 WA Primary

Addresses

Primary practice location

2500 W Sims Way Ste 300
Port Townsend, WA 98368-2234

Mailing address

2500 W Sims Way Ste 300
Port Townsend, WA 98368-2234
Phone (360) 385-0610

Other names 1

  • Shale Shore Other name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP61345795WAMDHospice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Public Hospital District No 2 Past Accepting new patients
Jefferson County Public Hospital District No 2 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.

NPI Registry JSON

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

{
    "created_epoch": "1777507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1336086073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W SIMS WAY STE 300",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682234",
            "telephone_number": "360-385-0610",
            "fax_number": "360-379-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W SIMS WAY STE 300",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682234",
            "telephone_number": "360-385-0610",
            "fax_number": "360-379-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "AMY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-30",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "WA",
            "license": "LP61345795",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WA",
            "license": "LP61345795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHALE",
            "last_name": "SHORE",
            "credential": "LPN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Townsend, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.