Active NPI
Gwendolyn Lee Sheveland, LMP
- Massage Therapist
- Spokane Valley, WA
National Provider Identifier
1376890863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 00020324
- Practice address
- 12929 E Sprague Ave
Ste 104
Spokane Valley, WA 99216-0721 - Phone
- (509) 891-2368
- NPI assigned
- Aug 14, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA 00020324 | WA | Primary |
Addresses
Primary practice location
12929 E Sprague Ave
Ste 104
Spokane Valley, WA 99216-0721
Mailing address
1212 S. Lloyd St.
Spokane, WA 99212
Phone (509) 413-2097
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA 00020324 | Other | WA | WASHINGTON DEPT. OF HEALTH MASSAGE PRACTITIONER LICENSE |
Other names 1
- Gwendolyn Lee Zirn
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA 00020324 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344902400000",
"number": "1376890863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 S. LLOYD ST.",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99212",
"telephone_number": "509-413-2097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12929 E SPRAGUE AVE",
"address_2": "STE 104",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992160721",
"telephone_number": "509-891-2368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEVELAND",
"first_name": "GWENDOLYN",
"middle_name": "LEE",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-14",
"last_updated": "2012-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA 00020324",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON DEPT. OF HEALTH MASSAGE PRACTITIONER LICENSE",
"identifier": "MA 00020324",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GWENDOLYN",
"last_name": "ZIRN",
"middle_name": "LEE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.