Shannan Jo Ross, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LW60268179 Issued in WA

Practice address

4301 S Pine St Ste 301
Tacoma, WA 98409-7206

Phone

(253) 476-6500

Fax

(253) 476-6547

NPI assigned

Sep 13, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1578998191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28118 19TH AVE E",
            "city": "ROY",
            "state": "WA",
            "postal_code": "985809506",
            "telephone_number": "253-254-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 S PINE ST STE 301",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097206",
            "telephone_number": "253-476-6500",
            "fax_number": "253-476-6547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28118 19th Ave E",
            "address_purpose": "LOCATION",
            "city": "Roy",
            "state": "WA",
            "postal_code": "985809506",
            "country_code": "US",
            "telephone_number": "253-254-2012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "SHANNAN",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW60268179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4301 S Pine St Ste 301",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984097206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fred Ross
• Kellie Ross
• Megyn Clara Ross, PEER SUPPORT
• Roy Ross II, SUDPT
• Scott Allen Ross, RN
• Alison Sue Rossdeutscher
• Jeanine Rossell
• Cynthia Rossi, CN
• Douglas C Rossi, PA-C
• Emily N. Rossin, RN

• Social Worker in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.