Malisa Shellman

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP61220017 Issued in WA

Practice address

9500 Front St S Ste 100
Lakewood, WA 98499-9415

Phone

(253) 393-2483

NPI assigned

Jun 26, 2024

Sex

Female

Sole proprietor

Yes

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": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1891530564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6306 E SARAZEN ST SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985138301",
            "telephone_number": "360-688-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 FRONT ST S STE 100",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984999415",
            "telephone_number": "253-393-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLMAN",
        "first_name": "MALISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP61220017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope Shaw
• Michael Haylett Shaw, HS
• Shawn Pham, DDS, PLLC.
• Jesssica Rose Sheinbaum
• Janie Shelby
• Janet R Shelstad, MA, LMFT
• Diane Ree Shepard, MA, LMHC
• Jillian Sheppard
• Charles William Sherrod
• Rachelle Kay Denman Sherwood, DPT

• Licensed Practical Nurse in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.