Provider Demographics
NPI:1043605405
Name:KRIER, SHELBY
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:KRIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20224 SE 232ND ST
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038
Mailing Address - Country:US
Mailing Address - Phone:206-639-3239
Mailing Address - Fax:
Practice Address - Street 1:10618 SE KENT KANGLEY RD
Practice Address - Street 2:SUITE 104
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-9048
Practice Address - Country:US
Practice Address - Phone:253-859-5433
Practice Address - Fax:253-859-4887
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60390131225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist