Active NPI
Debra Shanks, PTA
- Physical Therapy Assistant
- Edmonds, WA
National Provider Identifier
1679382675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- P160083963
- Practice address
- 424 3Rd Ave S Apt 407
Edmonds, WA 98020-3549 - Phone
- (425) 330-2263
- NPI assigned
- Jan 3, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | P160083963 | WA | Primary |
Addresses
Primary practice location
424 3Rd Ave S Apt 407
Edmonds, WA 98020-3549
Mailing address
424 3Rd Ave S Apt 407
Edmonds, WA 98020-3549
Phone (425) 330-2263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P160083963 | WA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735862400000",
"number": "1679382675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 3RD AVE S APT 407",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980203549",
"telephone_number": "425-330-2263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 3RD AVE S APT 407",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980203549",
"telephone_number": "425-330-2263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANKS",
"first_name": "DEBRA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-03",
"last_updated": "2025-01-03",
"certification_date": "2025-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WA",
"license": "P160083963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.