Mackenzie Raquel Sherman, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P160849298 Issued in WA

Practice address

25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697

Phone

(971) 364-0611

NPI assigned

May 8, 2023

Last updated

May 9, 2023By 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

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1770273468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697",
            "telephone_number": "971-364-0611",
            "fax_number": "971-364-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697",
            "telephone_number": "971-364-0611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25117 SW Parkway Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Wilsonville",
            "state": "OR",
            "postal_code": "970709697",
            "country_code": "US",
            "telephone_number": "971-364-0611",
            "fax_number": "971-364-0610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "MACKENZIE",
        "middle_name": "RAQUEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160849298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Ajit Shah, MD
• Michelle Shannon
• Marlene Shapiro, CCC/SLP
• Sarah Elizabeth Sharp, COTA
• Richard Scott Shaw, D.MFT
• Emilio Shivers, LMT
• Tawnya Shope, CADC II, QMHA-R
• Megan Siefkas, COTA/L
• Cameron M Sizemore, RN
• Skyline Anesthesia LLC

• Physical Therapy Assistant in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• Physical Therapy Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.