Shauna Fuller

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

24913 Issued in OR

Practice address

2927 NE Everett St
Portland, OR 97232-3248

Phone

(503) 232-6161

NPI assigned

Jan 10, 2020

Last updated

Jan 10, 2020By the provider in NPPES

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Everett & Flanders House Community Club

  • Massage Therapist
  • Portland, OR
  • NPI 1659904597
  NPD

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1689214314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2927 NE EVERETT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 NE EVERETT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323248",
            "telephone_number": "503-232-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SHAUNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "24913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Kay Fuller
• Lanisha Denise Fuller, MD
• Rachel Fuller
• Sara Fuller, LMHCA, LPC INTERN
• Sarah E Fuller, IBCLC
• Skylar Fuller
• Kathleen Fullerton, MSED
• Voneda Jane Fullerton, AA
• Ryan Austin Fullmer
• Alison Fulmer, M.D.

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; 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.