Elyssa Danae Shepard

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

4526 Federal Ave
Everett, WA 98203-2132

Phone

(425) 349-6200

NPI assigned

Apr 18, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1508429101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9007 105TH AVE SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984981970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032132",
            "telephone_number": "425-349-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "ELYSSA",
        "middle_name": "DANAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Lewis Shelton, PH.D.
• Lisa Rosemarie Shelton, ARNP
• Tina Shelton
• Emerisse Camille Shen, ARNP
• Michael S Shen, M.D.
• Dina Victorovna Shepelyuk, DNP, FNP-BC
• Kyle Christopher Shephard, M.D.
• Dominique Ann Shepherd
• Kymberly Ann Shepherd, COUNSELOR
• Steven P Shepherd, DO

• Behavior Technician in Everett, WA
• Providers in Everett, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.