Shane Thomas Branson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

21810 NE 37TH Ave
Ridgefield, WA 98642-7747

Phone

(360) 687-8555

NPI assigned

Oct 6, 2026

Last updated

Oct 6, 2026By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1791244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1508760141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12014 NW 19TH CT",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986852475",
            "telephone_number": "509-637-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21810 NE 37TH AVE",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986427747",
            "telephone_number": "360-687-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANSON",
        "first_name": "SHANE",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-06",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peer Specialist in Ridgefield, WA
• Providers in Ridgefield, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.