Active NPI
Shannon Sue Goldsberry, L.M.P.
- Mechanotherapist
- University Place, WA
National Provider Identifier
1497917819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MA00010503
- Practice address
- 7010 27TH St W
University Place, WA 98466-5215 - Phone
- (253) 534-8102
- Fax
- (253) 565-3346
- NPI assigned
- Jun 26, 2008
- 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 |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MA00010503 | WA | Primary |
Addresses
Primary practice location
7010 27TH St W
University Place, WA 98466-5215
Mailing address
7010 27TH St W
University Place, WA 98466-5215
Phone (253) 534-8102
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0182749 | Other | WA | WASHINGTON STATE DEPARTMENT OF LABOR AND INDUSTRIES |
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 |
|---|---|---|---|
| MA00010503 | WA | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214438400000",
"number": "1497917819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7010 27TH ST W",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984665215",
"telephone_number": "253-534-8102",
"fax_number": "253-565-3346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7010 27TH ST W",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984665215",
"telephone_number": "253-534-8102",
"fax_number": "253-565-3346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSBERRY",
"first_name": "SHANNON",
"middle_name": "SUE",
"credential": "L.M.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-26",
"last_updated": "2008-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "WA",
"license": "MA00010503",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE DEPARTMENT OF LABOR AND INDUSTRIES",
"identifier": "0182749",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in University Place, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.