Doctor Name: | MRS. SHANNON MARIE FREEMAN |
NPI Number: | 1407993900 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LAC, EAMP |
License Number: | MA12766 |
Business Practice Address: | 12 Bellwether Way Suite 219 Bellingham, WA - 982252959 |
Business Phone Number: | 3603664216 |
Business Fax Number: | 3603664241 |
Mailing Address: | Po Box 91, CUSTER |
State: | WA |
Postal Code: | 982400091 |
Phone Number: | 3603664216 |
Fax Number: | 3603664241 |
NPI Enumeration Date: | 01/31/2007 |
NPI Last Update Date: | 12/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA12766 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |