Provider Demographics
NPI:1346841269
Name:SHISH, COURTNEY MARIE (PT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:SHISH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 CALIFORNIA AVE SW STE 1A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4303
Mailing Address - Country:US
Mailing Address - Phone:206-938-0860
Mailing Address - Fax:206-398-0860
Practice Address - Street 1:3727 CALIFORNIA AVE SW STE 1A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4303
Practice Address - Country:US
Practice Address - Phone:206-938-0860
Practice Address - Fax:206-938-0860
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist