Provider Demographics
NPI:1407993900
Name:FREEMAN, SHANNON (EAMP,DIPLAC,LMP)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:EAMP,DIPLAC,LMP
Other - Prefix:MS
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EAMP,DIPLAC,LMP
Mailing Address - Street 1:1118 FINNEGAN WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6656
Mailing Address - Country:US
Mailing Address - Phone:360-366-4216
Mailing Address - Fax:360-366-4241
Practice Address - Street 1:1118 FINNEGAN WAY STE 201
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6656
Practice Address - Country:US
Practice Address - Phone:360-366-4216
Practice Address - Fax:360-366-4241
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60254073171100000X
WAMA12766225700000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA12766OtherWA MASSAGE LICENSE NUMBER
WA1932428919OtherNPI: A BETTER WAY MASSAGE, LLC, FERNDALE, WA
WAAC60254073OtherWASHINGTON STATE
WA6024SAOtherREGENCE PROVIDER NUMBER
WA1245656313OtherNPI NUMBER A BETTER WAY MASSAGE, LLC, BELLINGHAM, WA
WA1245656313OtherNPI NUMBER A BETTER WAY MASSAGE, LLC, BELLINGHAM, WA