Shawna Louise Wallace, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP00053254 Issued in WA

Practice address

502 4TH St NE
Auburn, WA 98002-5020

Phone

(253) 931-4927

NPI assigned

Apr 24, 2019

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

Other names 1

• Shawna Louise Bassham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Auburn School District

  • Local Education Agency (LEA)
  • Auburn, WA
  • NPI 1154350924
  NPD (past)

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1992369029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 4TH ST NE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980025020",
            "telephone_number": "253-931-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 4TH ST NE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980025020",
            "telephone_number": "253-931-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SHAWNA",
        "middle_name": "LOUISE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00053254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWNA",
            "last_name": "BASSHAM",
            "middle_name": "LOUISE",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walgreen Co
• Ishpinder K Walia, REGISTERED NURSE
• Jyotsana Walia, M.D.
• Richard David Walker Jr.
• Tanya Walker
• Heather Wallendahl
• John B Wallstrom, DDS
• Walmart Inc.
• Christina Walsh
• Emily Kastrup Walton, DNP-ARNP, RN

• Licensed Practical Nurse in Auburn, WA
• Providers in Auburn, 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 Apr 24, 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.