Active NPI
Shelley A Lange, MS, PT
- Physical Therapist
- Auburn, WA
National Provider Identifier
1851383723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00009123
- Practice address
- 720 12TH St SE
Auburn, WA 98002-6708 - Phone
- (253) 735-3606
- Fax
- (253) 351-9807
- NPI assigned
- Aug 17, 2005
- 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 Therapist | 225100000X | PT00009123 | WA | Primary |
Addresses
Primary practice location
720 12TH St SE
Auburn, WA 98002-6708
Mailing address
PO Box 2170
Sumner, WA 98390-0480
Phone (253) 840-2313
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 186057 | Other | WA | DEPT OF LABOR & INDUSTRIE |
| B022 | Other | WA | TRICARE |
| 8938038 | Other | WA | CRIME VICTIMS |
| 8162FE | Other | WA | REGENCE BLUE SHIELD |
| 8337396 | Medicaid | WA |
Other names 1
- Shelley A Federico
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)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297814400000",
"number": "1851383723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2170",
"city": "SUMNER",
"state": "WA",
"postal_code": "983900480",
"telephone_number": "253-840-2313",
"fax_number": "253-840-6340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 12TH ST SE",
"city": "AUBURN",
"state": "WA",
"postal_code": "980026708",
"telephone_number": "253-735-3606",
"fax_number": "253-351-9807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGE",
"first_name": "SHELLEY",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "MS, PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-17",
"last_updated": "2011-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00009123",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR & INDUSTRIE",
"identifier": "186057",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "B022",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8938038",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "8162FE",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8337396",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHELLEY",
"last_name": "FEDERICO",
"middle_name": "A",
"credential": "MS, PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.