Shelby Marie-Musu Bennett, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P161434678 Issued in WA

Practice address

6601 220TH St SW Ste 1
Mountlake Terrace, WA 98043-2166

Phone

(425) 458-5344

NPI assigned

Nov 13, 2023

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

State licenses

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1528832201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 220TH ST SW STE 1",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432166",
            "telephone_number": "425-458-5344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 220TH ST SW STE 1",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432166",
            "telephone_number": "425-458-5344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "SHELBY",
        "middle_name": "MARIE-MUSU",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P161434678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Allan Baxter, MD
• David Anthony Baylon
• Diandrea Joan Beckman, MSW, LSWAIC
• Behavior Interventionists of Puget Sound
• Jozette B Bell
• Bethel Berhanu
• Jennifer Leigh Bernard
• Craig Edward Bernhart, D.D.S.
• Stacy Bertsch, LMP
• Courtney Lee Binnion, LMHCA

• Physical Therapy Assistant in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.