Shannon L Moore, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP00054619 Issued in WA

Practice address

1235 3Rd Street
Sedro-Woolley, WA 98284

Phone

(360) 855-3510

NPI assigned

Dec 6, 2012

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": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1639414345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 3RD STREET",
            "city": "SEDRO-WOOLLEY",
            "state": "WA",
            "postal_code": "98284",
            "telephone_number": "360-855-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 3RD STREET",
            "city": "SEDRO-WOOLLEY",
            "state": "WA",
            "postal_code": "98284",
            "telephone_number": "360-855-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00054619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Matthew Moena
• John Lindsay Moody, MD
• Allya Elizabeth Moore, LMT
• Kimberly Moore, RN
• Michelle Rae Moore, MA, LMHC, NCC
• Susan Marie Moore, CCSH, RPSGT
• Devin Larry Morrison
• Elisabeth Morrison
• Susanna Eva Morse, RN
• Charitee Moses, NAR

• Licensed Practical Nurse in Sedro-Woolley, WA
• Providers in Sedro-Woolley, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.