Rebecca Ann Shadburne, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

19079 Issued in OR

Practice address

501 NE Hood Ave.
Suite 205
Gresham, OR 97030

Phone

(503) 674-7894

Fax

(503) 674-7899

NPI assigned

Oct 15, 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

Other names 1

• Rebecca Ann Norman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Active Family Chiropractic, LLC

  • Sports Physician Chiropractor
  • Gresham, OR
  • NPI 1104221530
  NPD (past)

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1730431735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 NE HOOD AVE.",
            "address_2": "SUITE 205",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-674-7894",
            "fax_number": "503-674-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 NE HOOD AVE.",
            "address_2": "SUITE 205",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-674-7894",
            "fax_number": "503-674-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADBURNE",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "19079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "NORMAN",
            "middle_name": "ANN",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tamara Lynn Serhan, L.M.T
• Lynette Marie Sestric
• Christopher J Severson, CADC I
• Rachel Severson, QMHA
• Delia Sewell, N.D.
• Jolynn Denise Shaffer, CRM II/QMHA-R
• Saghi Shahrokhi, DC
• Noran D Shamyer, LMT
• Harry Darden Shanks, QMHP
• Taylor Ann Sharman, PA-S

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.