Shelley K. Vessey, P.T.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

PT00009803 Issued in WA

Practice address

12033 SE 256TH St
Kent, WA 98030-6503

Phone

(253) 373-3711

NPI assigned

Jan 17, 2007

Last updated

Sep 24, 2012By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1336291616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34584",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241584",
            "telephone_number": "509-241-7349",
            "fax_number": "509-241-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12033 SE 256TH ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980306503",
            "telephone_number": "253-373-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESSEY",
        "first_name": "SHELLEY",
        "middle_name": "K.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "WA",
            "license": "PT00009803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8432270",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Joaquin Vidrio Efigenio
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• Jomari Villacruzes
• Paloma Villasenor

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Kent, WA
• Providers in Kent, WA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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.