Provider Demographics
NPI:1326353046
Name:BOUNDS, SHIRLEY MARIE (RRT)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:MARIE
Last Name:BOUNDS
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 ROUGE STREET
Mailing Address - Street 2:PO BOX 626
Mailing Address - City:WINSTON
Mailing Address - State:OR
Mailing Address - Zip Code:97496
Mailing Address - Country:US
Mailing Address - Phone:541-285-4595
Mailing Address - Fax:
Practice Address - Street 1:2900 CHARLEVOIX DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7085
Practice Address - Country:US
Practice Address - Phone:800-634-9581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRT-P-001297227900000X
CA00029024227900000X
AZ008806227900000X
FLRT 10018227900000X
WALR 00003229227900000X
IN30007580A227900000X
VT122-0000441227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered