Marrisa L Shaw

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

CO60925720 Issued in WA

Practice address

884 W Park Ave
Port Townsend, WA 98368-2273

Phone

(360) 385-0321

NPI assigned

Nov 13, 2019

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

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/discoverybh/r4/

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.

• Jefferson Community Counseling Center

  • Community/Behavioral Health Agency
  • Port Townsend, WA
  • NPI 1083701015
  NPD
• Madrona Institute of Washington

  • Addiction (Substance Use Disorder) Counselor
  • Port Townsend, WA
  • NPI 1154410876
  NPD (past)

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1740825819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 565",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983680565",
            "telephone_number": "360-385-0321",
            "fax_number": "360-385-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 W PARK AVE",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682273",
            "telephone_number": "360-385-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MARRISA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "CO60925720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selena Sena-Hopkins, MA, LMHC
• Shannon L. Servin-Obert, D.O.
• Jamie Seton
• Edward A Shapiro, M.D.
• Steven Shapiro
• Teresa Ann Shelley, RN
• Charlene Sherwood, PT
• Camille Elizabeth Shiflett, RN
• Samuel M Shirk, M.D.
• Logan Kerrick Shores, RN

• Student in an Organized Health Care Education/Training Program in Port Townsend, WA
• Providers in Port Townsend, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.