Shanda Lynn Whitney, LMT
Individual provider Active NPI Massage Therapist · Roy, WA
NPI 1649776402 · NPPES record last updated Mar 21, 2024
Key facts
- NPI
- 1649776402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA60014635 (WA)
- Practice address
- 29606 73Rd Avenue CT S
Roy, WA 98580-4518 - Phone
- (253) 225-9163
- NPI assigned
- Apr 2, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60014635 | WA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60014635 | WA | Yes |
Addresses
Primary practice location
29606 73Rd Avenue CT S
Roy, WA 98580-4518
Mailing address
29606 73Rd Avenue CT S
Roy, WA 98580-4518
Phone (253) 225-9163
Other providers in Roy, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.