Individual provider Active NPI

Pamela Jeanne Sheehan, PTA

  • Physical Therapy Assistant
  • Lynnwood, WA
National Provider Identifier
1336493576
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P1 60033358 Issued in WA
Practice address
4320 196TH St SW
Lynnwood, WA 98036-6773
Phone
(425) 967-0051
Fax
(425) 967-0053
NPI assigned
Nov 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P1 60033358 WA Primary

Addresses

Primary practice location

4320 196TH St SW
Lynnwood, WA 98036-6773

Mailing address

4320 196TH St SW
Lynnwood, WA 98036-6773
Phone (425) 967-0051

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
P1 60033358WAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
U.S. Healthworks Medical Group of Washington, PS Past Accepting new patients

Organizations & group practices 1

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": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1336493576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 196TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366773",
            "telephone_number": "425-967-0051",
            "fax_number": "425-967-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 196TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366773",
            "telephone_number": "425-967-0051",
            "fax_number": "425-967-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "PAMELA",
        "middle_name": "JEANNE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P1 60033358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.