Individual provider Active NPI

Cheryl Ann Shamiraden

  • Counselor
  • Olympia, WA
National Provider Identifier
1871761056
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
RC00004647 Issued in WA
Practice address
3030 Limited LN NW
Olympia, WA 98502-2704
Phone
(360) 491-1399
Fax
(360) 491-1623
NPI assigned
Feb 11, 2008
Last updated
Feb 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X RC00004647 WA Primary

Addresses

Primary practice location

3030 Limited LN NW
Olympia, WA 98502-2704

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (206) 764-3335

Other names 1

  • Cheryl Ann Homan Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RC00004647WAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1871761056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-3335",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 LIMITED LN NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985022704",
            "telephone_number": "360-491-1399",
            "fax_number": "360-491-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMIRADEN",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC00004647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "HOMAN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.